Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020
Objectives In Mexico, patients with systemic arterial hypertension (SAH) are excluded from the influenza vaccination programme despite their risk of cardiovascular events as influenza-related complications. We investigated the impact of influenza on morbidity and mortality in patients with SAH.Desig...
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e057225.full |
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| author | ROBERTO TAPIA-CONYER Alejandrina Malacara-Villaseñor Hermes Ilaraza-Lomeli Elsa Sarti |
| author_facet | ROBERTO TAPIA-CONYER Alejandrina Malacara-Villaseñor Hermes Ilaraza-Lomeli Elsa Sarti |
| author_sort | ROBERTO TAPIA-CONYER |
| collection | DOAJ |
| description | Objectives In Mexico, patients with systemic arterial hypertension (SAH) are excluded from the influenza vaccination programme despite their risk of cardiovascular events as influenza-related complications. We investigated the impact of influenza on morbidity and mortality in patients with SAH.Design This was a retrospective cross-sectional study that analysed data from early 2014 to mid-2020.Setting Data were obtained from the Influenza Epidemiological Surveillance System in Mexico database.Participants 32 663 cases of influenza in people aged ≥20 years with a confirmed case of influenza-like illness, severe respiratory infection and/or influenza death were investigated.Primary and secondary outcome measures Influenza deaths, hospitalisation frequency and the impact on hospitalisation and/or death due to influenza by the SAH variate alone and in combination with diabetes, obesity, chronic obstructive pulmonary disease, cardiovascular disease and/or smoking, and by vaccination status were assessed.Results The hospitalisation frequency increased with age. Notably, 46.0% (15 033/32 663) of confirmed influenza cases had at least one comorbidity, with SAH (19.2%; 6260/32 663) and obesity (18.7%; 6106/32 663) being the most prevalent. Most confirmed SAH cases (80.8%; 5057/6260) were in those who had not been vaccinated against influenza. There were 3496 deaths due to influenza (mortality rate, 0.69×1 00 000 inhabitants), with the highest rates seen in those aged ≥80 years (80–89 years, 2.0%; ≥90 years, 3.6%). The case fatality rate due to influenza and SAH was significantly higher than those due to influenza without SAH in those aged <50 years, but not in the other age groups (20–29 years, 9.8%, p<0.0005; 30–39 years, 8.2%, p<0.035; 40–49 years, 17.8%, p<0.0005; vs 15.1%–20.0%, p=0.31–0.99 for those aged ≥50 years).Conclusions Our findings support the need to include SAH in public policies of influenza vaccination as a secondary prevention measure to avoid fatal outcomes. |
| format | Article |
| id | doaj-art-009c024a6a7a4cdf8e4b0e04d87f87b3 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-009c024a6a7a4cdf8e4b0e04d87f87b32024-12-08T11:55:09ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-057225Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020ROBERTO TAPIA-CONYER0Alejandrina Malacara-Villaseñor1Hermes Ilaraza-Lomeli2Elsa Sarti3Faculty of Medicine, National Autonomous University of Mexico, Mexico City, MexicoDepartamento Medico, Sanofi Pasteur Mexico, Ciudad de Mexico, MexicoRehabilitacion Cardiaca, Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, MexicoDepartamento Medico, Sanofi Pasteur Mexico, Ciudad de Mexico, MexicoObjectives In Mexico, patients with systemic arterial hypertension (SAH) are excluded from the influenza vaccination programme despite their risk of cardiovascular events as influenza-related complications. We investigated the impact of influenza on morbidity and mortality in patients with SAH.Design This was a retrospective cross-sectional study that analysed data from early 2014 to mid-2020.Setting Data were obtained from the Influenza Epidemiological Surveillance System in Mexico database.Participants 32 663 cases of influenza in people aged ≥20 years with a confirmed case of influenza-like illness, severe respiratory infection and/or influenza death were investigated.Primary and secondary outcome measures Influenza deaths, hospitalisation frequency and the impact on hospitalisation and/or death due to influenza by the SAH variate alone and in combination with diabetes, obesity, chronic obstructive pulmonary disease, cardiovascular disease and/or smoking, and by vaccination status were assessed.Results The hospitalisation frequency increased with age. Notably, 46.0% (15 033/32 663) of confirmed influenza cases had at least one comorbidity, with SAH (19.2%; 6260/32 663) and obesity (18.7%; 6106/32 663) being the most prevalent. Most confirmed SAH cases (80.8%; 5057/6260) were in those who had not been vaccinated against influenza. There were 3496 deaths due to influenza (mortality rate, 0.69×1 00 000 inhabitants), with the highest rates seen in those aged ≥80 years (80–89 years, 2.0%; ≥90 years, 3.6%). The case fatality rate due to influenza and SAH was significantly higher than those due to influenza without SAH in those aged <50 years, but not in the other age groups (20–29 years, 9.8%, p<0.0005; 30–39 years, 8.2%, p<0.035; 40–49 years, 17.8%, p<0.0005; vs 15.1%–20.0%, p=0.31–0.99 for those aged ≥50 years).Conclusions Our findings support the need to include SAH in public policies of influenza vaccination as a secondary prevention measure to avoid fatal outcomes.https://bmjopen.bmj.com/content/11/12/e057225.full |
| spellingShingle | ROBERTO TAPIA-CONYER Alejandrina Malacara-Villaseñor Hermes Ilaraza-Lomeli Elsa Sarti Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 BMJ Open |
| title | Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 |
| title_full | Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 |
| title_fullStr | Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 |
| title_full_unstemmed | Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 |
| title_short | Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020 |
| title_sort | influenza and morbidity and mortality risk in patients in mexico with systemic arterial hypertension alone or with comorbidities a retrospective observational cross sectional study from 2014 to 2020 |
| url | https://bmjopen.bmj.com/content/11/12/e057225.full |
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