Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.

TitleCentrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.
Publication TypeJournal Article
Year of Publication2023
AuthorsGeorge, CJ, Hall, CB, Weiss, EF, Verghese, J, Neptune, E, Abadir, P
JournalJ Frailty Aging
Date Published2023
ISSN Number2260-1341
KeywordsAged, Angiotensin-Converting Enzyme Inhibitors, Cross-Sectional Studies, Hand Strength, Humans, Muscle Strength, Physical Functional Performance

BACKGROUND: There is conflicting evidence regarding the role of angiotensin-converting enzyme inhibitors and physical function. While some studies show improvements in muscle strength and physical function, others show no significant difference or decreased performance. This ambiguity could be due to differential effects of angiotensin-converting enzyme inhibitor subtypes which can be categorized as centrally or peripherally-acting based upon their ability to cross the blood-brain barrier.

OBJECTIVE: The objective of this study is to compare physical performance measures among angiotensin-converting enzyme inhibitor subtype users.

METHODS: Design: Cross-sectional Setting: Ambulatory Participants: Performed in 364 participants in the Health and Retirement Study cohort who were ≥ 65 years (median age (IQR) 74.00 (69-80) years.

MEASUREMENTS: Average difference in hand grip (kg), gait speed(m/s) and peak expiratory flow (L/min).

RESULTS: Compared to participants on a peripherally-acting angiotensin-converting enzyme inhibitor (113 (31%)), those on a centrally-acting agent (251(69%)) had stronger grip strength 28.9 ±1.0 vs 26.3±1.0, p=.011 and higher peak expiratory flow rates 316.8±130.4 vs. 280.0±118.5, p= .011 in unadjusted analysis. After multiple adjustments the difference in PEF remained statistically significant (Estimate(CI) 26.5, 95% CI 2.24, 50.5, p = 0.032).

CONCLUSION: Our results suggest that in older adults the use of centrally-acting angiotensin-converting enzyme inhibitors compared to a peripherally acting angiotensin-converting enzyme inhibitors was associated with better lung function in older individuals.

Citation Key13137
PubMed ID36946705
PubMed Central IDPMC10111793
Grant ListK23 AG062807 / AG / NIA NIH HHS / United States