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

Deepa Sumukadas (Lead / Corresponding author), Margaret Band, Suzanne Miller, Vera Cvoro, Miles Witham, Allan Struthers, Alex McConnachie, Suzanne M. Lloyd, Marion McMurdo

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    Abstract

    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. Methods. 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.
    Results. 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)
     Interpretation. ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.   Author.
    Original languageEnglish
    Pages (from-to)736-743
    Number of pages8
    JournalThe Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
    Volume69
    Issue number6
    DOIs
    Publication statusPublished - Jun 2014

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    Perindopril
    Angiotensin-Converting Enzyme Inhibitors
    Randomized Controlled Trials
    Placebos
    Exercise
    Enzyme Therapy
    Independent Living
    Family Practice
    Muscle Strength
    General Practice
    Quality of Life
    Confidence Intervals
    Morbidity
    Education
    Therapeutics

    Cite this

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    title = "Do ACE inhibitors improve the response to exercise training in functionally impaired older adults?: A randomized controlled trial",
    abstract = "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. Methods. 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. Results. 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) Interpretation. ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.   Author.",
    author = "Deepa Sumukadas and Margaret Band and Suzanne Miller and Vera Cvoro and Miles Witham and Allan Struthers and Alex McConnachie and Lloyd, {Suzanne M.} and Marion McMurdo",
    year = "2014",
    month = "6",
    doi = "10.1093/gerona/glt142",
    language = "English",
    volume = "69",
    pages = "736--743",
    journal = "The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences",
    issn = "1079-5006",
    publisher = "Oxford University Press",
    number = "6",

    }

    TY - JOUR

    T1 - Do ACE inhibitors improve the response to exercise training in functionally impaired older adults?

    T2 - A randomized controlled trial

    AU - Sumukadas, Deepa

    AU - Band, Margaret

    AU - Miller, Suzanne

    AU - Cvoro, Vera

    AU - Witham, Miles

    AU - Struthers, Allan

    AU - McConnachie, Alex

    AU - Lloyd, Suzanne M.

    AU - McMurdo, Marion

    PY - 2014/6

    Y1 - 2014/6

    N2 - 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. Methods. 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. Results. 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) Interpretation. ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.   Author.

    AB - 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. Methods. 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. Results. 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) Interpretation. ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.   Author.

    U2 - 10.1093/gerona/glt142

    DO - 10.1093/gerona/glt142

    M3 - Article

    C2 - 24201696

    VL - 69

    SP - 736

    EP - 743

    JO - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

    JF - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

    SN - 1079-5006

    IS - 6

    ER -