Relation between use of angiotensin-converting enzyme inhibitors and muscle strength and physical function in older women: an observational study
Abstract
Background Angiotensin-converting enzyme (ACE) inhibitors prevent decline in physical function in patients with congestive heart failure (CHF). We aimed to see whether ACE inhibitors also prevent reduction in physical performance and in muscle strength in older women who do not have CHF.Methods We assessed 3-year rates of decline in both knee extensor muscle strength and walking speed in 641 women with hypertension who had participated in the Women's Health and Aging Study. Women were stratified into four groups according to type and duration of antihypertensive drug treatment. 61 had used ACE inhibitors continuously, 133 intermittently, 146 never, and 301 had used other hypertensive drugs either continuously or intermittently.Findings Participants who had taken ACE inhibitors continuously had a lower mean 3-year decline in muscle strength of -1.0 kg (SE 1.1) compared with -3.7 (0.5) kg in continuous/intermittent users of other antihypertensive drugs (p=0.016) and with -3.9 kg in those who had never used antihypertensives (p=0.026). Muscle strength fell by 3.0 kg in 3 years in both continuous and intermittent users of ACE inhibitors (p=0.096). Mean 3-year decline in walking speed in continuous ACE inhibitor users was -1.7 cm/s compared with -13.6 cm/s in intermittent users of ACE inhibitors (p=0.015), -15.7 cm/s in continuous/intermittent users of other antihypertensive drugs (p=0.002), and -17.9 cm/s in never users of antihypertensive drugs (p=0.001).Interpretation ACE inhibitor treatment may halt or slow decline in muscle strength in elderly women with hypertension and without CHF.
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Testosterone improves muscle strength but also increases adverse cardiovascular and respiratory outcomes.
“Testosterone improves muscle strength but also increases adverse cardiovascular and respiratory outcomes (131).”
From Frailty in elderly people (2013) · cites this paper as [131]
Epidemiologic evidence from the Women's Health and Aging Study and the Systematic Assessment of Geriatric drug use via Epidemiology Study indicated that older adults using ACE inhibitors had attenuated declines in walking speed and fewer ADL limitations compared to non-users.
“Epidemiologic evidence from the Women’s Health and Aging Study and the Systematic Assessment of Geriatric drug use via Epidemiology Study indicated that, compared to non-users, older adults using ACE inhibitors displayed attenuated declines in walking speed and fewer limitations in ADLs.(Gambassi, Lapane, Sgadari, Carbonin, Gatsonis, Lipsitz, Mor, and Bernabei 2000;Onder, Penninx, Balkrishnan, F”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Onder, Penninx, Balkrishnan, Fried, Chaves, Williamson, Carter, Di, Guralnik, and Pahor 2002
Other epidemiologic and animal evidence suggests that these outcomes may have been due to attenuated declines in skeletal muscle mass and strength.
“Other epidemiologic and animal evidence suggests that these outcomes may have been due to attenuated declines in skeletal muscle mass and strength.(Carter, Marzetti, Leeuwenburgh, Manini, Foster, Groban, Scarpace, and Morgan 2012;Di, van de Poll-Franse LV, Onder, Kritchevsky, Newman, Harris, Williamson, Marchionni, and Pahor 2004;Onder, Penninx, Balkrishnan, Fried, Chaves, Williamson, Carter, Di,”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Onder, Penninx, Balkrishnan, Fried, Chaves, Williamson, Carter, Di, Guralnik, and Pahor 2002
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- Authors
- Onder, G., Penninx, B. W., Balkrishnan, R., Fried, L. P., Chaves, P. H., Williamson, J., Carter, C., Bari, M. D., Guralnik, J. M., & Pahor, M.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Wake Forest University Health Sciences (US)
- Johns Hopkins University (US)
- National Institutes of Health (US)
- Corresponding author
- Onder, Graziano
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2002-03
- Volume
- 359
- Issue
- 9310
- Pages
- 926-930
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2055427232
- Cited by
- 339
- References
- 34
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 20 · 2023: 15 · 2022: 16 · 2021: 22 · 2020: 18 · 2019: 11 · 2018: 16 · 2017: 20 · 2016: 22 · 2015: 20 · 2014: 19 · 2013: 14 · 2012: 11
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Funders
- National Institutes of Health (n01ag012112-014)
- National Institute on Aging (5P60 AG10484-07, N01AG12112, P60AG010484)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- ACE inhibitors, muscle strength, physical function, older women, hypertension, walking speed, quadriceps strength, functional decline, antihypertensive drugs, Women's Health and Aging Study
- MeSH terms
- Aged, Aging, Analysis of Variance, Angiotensin-Converting Enzyme Inhibitors, Female, Humans, Hypertension, Muscles, Physical Fitness, Walking
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