To the Editors:
In a recent issue of the European Respiratory Journal, van de Garde et al. 1 demonstrated that the use of angiotensin-converting enzyme (ACE) inhibitors is not associated with a decreased risk of hospitalisation for community-acquired pneumonia (CAP) in a general, essentially white population. Their conclusion that the beneficial effect of ACE inhibitors on pneumonia risk is not observed in a general white population is in contrast with previous findings in Asian populations 1. This was an excellent good study examining the association of ACE inhibitor treatment of cardiovascular disease with a risk reduction of CAP using a large sample size. The results are acceptable and not surprising; however, the discussion and conclusion are misleading.
As shown in table 1⇓, there are controversies regarding the ACE inhibitor effects on the risk reduction of pneumonia even in Asian countries; furthermore, the study samples are very different among the studies. In a prospective study …