The Association between Influenza Vaccination and Stroke Risk in Patients with Hypertension: A Nationwide Population-Based Study

Cheng Hsin Lin, Chun Chih Chiu, Tsung Yeh Yang, Yu Ann Fang, Meng Huan Lei, Hsien Tang Yeh, Chun Chao Chen, Wen Rui Hao, Chung Hsien Kuo, Ju Chi Liu

Research output: Contribution to journalArticlepeer-review

Abstract

There is evidence of strong association between influenza infections and stroke; however, the influenza vaccination and its effect on strokes is currently unclear. In the present study, Taiwan’s National Health Insurance Database was used in obtaining data for study subjects 55 years and older diagnosed with hypertension (n = 59,251; 25,266 vaccinated and 33,985 unvaccinated subjects) from 2001–2012. Propensity scores were calculated using a logistic regression model to determine the effects of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) for stroke in vaccinated and unvaccinated patients. Influenza vaccination was associated with a 42%, 40% and 44% stroke risk reduction in the entire cohort for all seasons, the influenza season and the non-influenza season, respectively (Adjust hazard ratio [aHR]: 0.58, 95% confidence interval [CI]: 0.56–0.61; aHR: 0.60, 95% CI: 0.56–0.63; aHR: 0.56, 95% CI: 0.52–0.60, for all seasons, the influenza season and the non-influenza season, respectively). The effect of risk reduction by vaccination also revealed a trend of dose dependency. Among subjects between 55 to 64 years old with four or more vaccinations during the study period, there is a 73% risk reduction for stroke during the non-influenza season (aHR: 0.27, 95% CI: 0.20–0.34). In conclusion, the influenza vaccination exerts dose-dependent and synergistic protective effects against stroke in individuals 55 years and older with hypertension.

Original languageEnglish
Article number4074
JournalApplied Sciences (Switzerland)
Volume12
Issue number8
DOIs
Publication statusPublished - Apr 1 2022

Keywords

  • hypertension
  • influenza vaccination
  • stroke

ASJC Scopus subject areas

  • Materials Science(all)
  • Instrumentation
  • Engineering(all)
  • Process Chemistry and Technology
  • Computer Science Applications
  • Fluid Flow and Transfer Processes

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