JOURNAL ARTICLE
MULTICENTER STUDY
RANDOMIZED CONTROLLED TRIAL

Angiotensin-converting enzyme inhibitor use by older adults is associated with greater functional responses to exercise

Thomas W Buford, Todd M Manini, Fang-Chi Hsu, Matteo Cesari, Stephen D Anton, Susan Nayfield, Randall S Stafford, Timothy S Church, Marco Pahor, Christy S Carter
Journal of the American Geriatrics Society 2012, 60 (7): 1244-52
22726232

OBJECTIVES: To assess the association between angiotensin converting enzyme inhibitors (ACEis) and improvements in the physical function of older adults in response to chronic exercise training.

DESIGN: Secondary analysis of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a multisite randomized clinical trial to evaluate the effects of chronic exercise on the physical function of older adults at risk for mobility disability.

SETTING: Four academic research centers within the United States.

PARTICIPANTS: Four hundred twenty-four individuals aged 70 to 89 with mild to moderate functional impairments categorized for this analysis as ACEi users, users of other antihypertensive drugs, or antihypertensive nonusers.

INTERVENTION: A 12-month intervention of structured physical activity (PA) or health education promoting successful aging (SA).

MEASUREMENTS: Change in walking speed during a 400-m test and performance on a battery of short-duration mobility tasks (Short Physical Performance Battery (SPPB)).

RESULTS: Physical activity significantly improved the adjusted walking speed of ACEi users (P < .001) but did not of nonusers. PA improved the adjusted SPPB score of ACEi users (P < .001) and of persons who used other antihypertensive drugs (P = .005) but not of antihypertensive nonusers (P = .91).The percentage of ACEi users deriving clinically significant benefit from exercise training for walking speed (30%) and SPPB score (48%) was dramatically higher than for nonusers (14% and 12%, respectively).

CONCLUSION: For older adults at risk for disability, exercise-derived improvements in physical function were greater for ACEi users than users of other antihypertensive drugs and antihypertensive nonusers.

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