Do ACE inhibitors improve the response to exercise training in functionally impaired older adults? A randomized controlled trial

Sumukadas, D., Band, M., Miller, S., Cvoro, V., Witham, M., Struthers, A., McConnachie, A. , Lloyd, S. M. and McMurdo, M. (2014) Do ACE inhibitors improve the response to exercise training in functionally impaired older adults? A randomized controlled trial. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(6), pp. 736-743. (doi: 10.1093/gerona/glt142)

Abstract

<br>Background: Loss of muscle mass and strength with ageing is a major cause for falls, disability, and morbidity in older people. Previous studies have found that angiotensin-converting enzyme inhibitors (ACEi) may improve physical function in older people. It is unclear whether ACEi provide additional benefit when added to a standard exercise training program. We examined the effects of ACEi therapy on physical function in older people undergoing exercise training.</br> <b>Methods:</b> Community-dwelling people aged ≥65 years with functional impairment were recruited through general (family) practices. All participants received progressive exercise training. Participants were randomized to receive either 4 mg perindopril or matching placebo daily for 20 weeks. The primary outcome was between-group change in 6-minute walk distance from baseline to 20 weeks. Secondary outcomes included changes in Short Physical Performance Battery, handgrip and quadriceps strength, self-reported quality of life using the EQ-5D, and functional impairment measured using the Functional Limitations Profile.<p></p> <b>Results:</b> A total of 170 participants (n = 86 perindopril, n = 84 placebo) were randomized. Mean age was 75.7 (standard deviation [SD] 6.8) years. Baseline 6-minute walk distance was 306 m (SD 99). Both groups increased their walk distance (by 29.6 m perindopril, 36.4 m placebo group) at 20 weeks, but there was no statistically significant treatment effect between groups (−8.6m [95% confidence interval: −30.1, 12.9], p = .43). No statistically significant treatment effects were observed between groups for the secondary outcomes. Adverse events leading to withdrawal were few (n = 0 perindopril, n = 4 placebo).<p></p> <b>Interpretation:</b> ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.<p></p>

• Item Type: Articles (Other)
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lloyd, Miss Suzanne and McConnachie, Professor Alex
• Authors: Sumukadas, D., Band, M., Miller, S., Cvoro, V., Witham, M., Struthers, A., McConnachie, A., Lloyd, S. M., and McMurdo, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Journals of Gerontology Series A: Biological Sciences and Medical Sciences
• Publisher: Oxford University Press
• ISSN: 1079-5006
• ISSN (Online): 1758-535X
• Copyright Holders: Copyright © 2013 The Authors
• First Published: First published in The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 69(6):736-743
• Publisher Policy: Reproduced under a Creative Commons License

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