Flu Vaccine and Mortality in Hypertension:A Nationwide Cohort Study

BACKGROUND: Influenza infection may increase the risk of stroke and acute myocardial infarction (AMI). Whether influenza vaccination may reduce mortality in patients with hypertension is currently unknown. METHODS AND RESULTS: We performed a nationwide cohort study including all patients with hypertension in Denmark during 9 consecutive influenza seasons in the period 2007 to 2016 who were prescribed at least 2 different classes of antihypertensive medication (renin‐angiotensin system inhibitors, diuretics, calcium antagonists, or beta‐blockers). We excluded patients who were aged 100 years, had ischemic heart disease, heart failure, chronic obstructive lung disease, cancer, or cerebrovascular disease. The exposure to influenza vaccination was assessed before each influenza season. The end points were defined as death from all‐causes, from cardiovascular causes, or from stroke or AMI. For each influenza season, patients were followed from December 1 until April 1 the next year. We included a total of 608 452 patients. The median follow‐up was 5 seasons (interquartile range, 2–8 seasons) resulting in a total follow‐up time of 975 902 person‐years. Vaccine coverage ranged from 26% to 36% during the study seasons. During follow‐up 21 571 patients died of all‐causes (3.5%), 12 270 patients died of cardiovascular causes (2.0%), and 3846 patients died of AMI/stroke (0.6%). After adjusting for confounders, vaccination was significantly associated with reduced risks of all‐cause death (HR, 0.82; P<0.001), cardiovascular death (HR, 0.84; P<0.001), and death from AMI/stroke (HR, 0.90; P=0.017). CONCLUSIONS: Influenza vaccination was significantly associated with reduced risks of death from all‐causes, cardiovascular causes, and AMI/stroke in patients with hypertension. Influenza vaccination might improve outcome in hypertension

Feasibility of a collective Thomson scattering diagnostic for burning plasma control on DEMO

Diagnostic systems are essential for burning plasma control and operation of DEMO, but are at the same time challenging in terms of design and integration. The harsh environment around the DEMO plasma, and the space restrictions and need to maximize the first-wall area used for tritium breeding, set limitations on the number and type of diagnostics to be installed. This will focus the efforts on diagnostics needed for control of the DEMO plasma. The robustness and versatility of a microwave-based Collective Thomson Scattering (CTS) diagnostic make it worthwhile to investigate the potential of a DEMO CTS diagnostic. We present the initial exploratory effort on this. The study builds on the experience of existing CTS experiments on e.g. ASDEX Upgrade, and on the recent development of the ITER CTS system, which focuses on measurements of fast ion dynamics in the burning ITER plasma. The initial target of the DEMO CTS diagnostic was to use an Electron Cyclotron Resonance Heating (ECRH) gyrotron beam as the probing source, with the receiving quasi-optical system being a dedicated CTS setup. Based on raytracing calculations including signal-to-noise estimates, it is found that such a setup is not viable. Here, we present studies of alternative solutions, including assessments of which DEMO plasma parameters the CTS diagnostic may contribute to determine.</p