ACE and susceptibility to pneumonia measurement: We conducted a subgroup analysis of elderly adults because of the higher incidence of silent aspiration among elderly patients with community-acquired pneumonia.2 The 2009 Japanese Society of Hypertension (JSH) Guidelines for the Management of Hypertension specify the use of ACE inhibitors for hypertensive patients with repeated aspiration pneumonia, including silent aspiration.29 In our subgroup analysis, there was no significant association between ACE inhibitor use and pneumonia among elderly adults.