C J George, C B Hall, E F Weiss, J Verghese, E Neptune, P Abadir
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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.</p><p><strong>Objective: </strong>The objective of this study is to compare physical performance measures among angiotensin-converting enzyme inhibitor subtype users.</p><p><strong>Methods: </strong>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.</p><p><strong>Measurements: </strong>Average difference in hand grip (kg), gait speed(m/s) and peak expiratory flow (L/min).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111793/pdf/","citationCount":"0","resultStr":"{\"title\":\"Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.\",\"authors\":\"C J George, C B Hall, E F Weiss, J Verghese, E Neptune, P Abadir\",\"doi\":\"10.14283/jfa.2023.10\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There is conflicting evidence regarding the role of angiotensin-converting enzyme inhibitors and physical function. 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引用次数: 0
摘要
背景:关于血管紧张素转换酶抑制剂和身体功能的作用，有相互矛盾的证据。虽然一些研究显示肌肉力量和身体功能有所改善，但其他研究显示没有显著差异或性能下降。这种模糊性可能是由于血管紧张素转换酶抑制剂亚型的不同作用，这些亚型可根据其穿越血脑屏障的能力分为中枢作用或外周作用。目的:本研究的目的是比较血管紧张素转换酶抑制剂亚型使用者的身体表现指标。设计:横断面设置:门诊参与者:健康与退休研究队列中364名≥65岁(中位年龄(IQR) 74.00(69-80)岁)的参与者。测量方法:平均握力差(kg)、步速差(m/s)、呼气峰流量差(L/min)。结果:与使用外周作用血管紧张素转换酶抑制剂(113(31%))的参与者相比，使用中央作用药物(251(69%))的参与者握力更强(28.9±1.0 vs 26.3±1.0)，p=。呼气流量峰值316.8±130.4比280.0±118.5,p= 0.011。经过多次调整后，PEF的差异仍然具有统计学意义(估计CI为26.5,95% CI为2.24,50.5,p = 0.032)。结论:我们的研究结果表明，在老年人中，与外周作用的血管紧张素转换酶抑制剂相比，使用中枢作用的血管紧张素转换酶抑制剂与老年人更好的肺功能相关。
Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.
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.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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