ACE inhibitors are known to prevent the decline in physical function in patients with congestive heart failure (CHF). Graziano Onder and colleagues from Wake Forest University, USA, investigated whether ACE inhibitors could also prevent reduction in physical performance and in muscle strength in elderly women who did not have CHF.
3-year rates of decline in the strength of the extensor muscle around the knee and walking-speed reduction was assessed in 641 women with hypertension. The participants (whose average age was 79 years) had taken part in the Women’s Health and Aging Study, and were stratified into four groups depending on their type and duration of antihypertensive drug treatment. 61 had used ACE inhibitors continuously, 133 intermittently, 301 had used other antihypertensive drugs either continuously or intermittently and 146 had never used antihypertensive drugs.
Women who were continuous users of ACE inhibitors had a lower average 3-year decline in muscle strength of 1 kg compared with a decline of 3.7 kg in continuous/intermittent users of other antihypertensive drugs. Women who had never used antihypertensive drugs had an average decline in muscle strength of 3.9 kg. Continuous ACE inhibitor users had a substantially smaller reduction in 3-year walking speed (1.7 cm per second) compared with intermittent users of ACE inhibitors (13.6 cm per second). The 3-year walking-speed reduction was substantially greater in intermittent users of other antihypertensive drugs (15.7 cm per second) and for women who did not use antihypertensive drugs at all (17.9 cm per second reduction in speed).
Graziano Onder comments: “Our results suggest that ACE inhibitor treatment could decrease long-term decline in physical function in elderly women who do not have CHF. If these findings can be confirmed in randomised controlled trials, ACE inhibitors could not only be used as first-line treatment of older adults with hypertension, but could also be used to slow physical decline in elderly people.”
Journal
The Lancet