Key result
ACE inhibitors linked to better muscle function and reduced physical decline in older adults.
Why the study?
ACE inhibitors reduce morbidity and physical decline in CHF patients, but their direct effects on skeletal muscle and potential to prevent physical decline in older adults require further confirmation.
Do ACE inhibitors improve physical performance and skeletal muscle function in older adults?
Do ACE inhibitors improve physical performance and skeletal muscle function in older adults?
ACE inhibitors may have direct beneficial effects on skeletal muscle, highlighting a potential intervention to prevent physical decline in the elderly.
Direct skeletal muscle effects may contribute to ACE inhibitor benefits in CHF; hypothesis-generating from Level 5 data and requires randomized confirmation.
Angiotensin-converting enzyme (ACE) inhibitors reduce morbidity, mortality, hospital admissions, and decline in physical function and exercise capacity in congestive heart failure (CHF) patients. These therapeutic effects are attributed primarily to beneficial cardiovascular actions of these drugs. However, it has been suggested that ACE inhibitor-induced positive effects may also be mediated by direct action on the skeletal muscle. In particular, two recently published observational studies documented that among hypertensive subjects free of CHF, treatment with ACE inhibitors was associated with better performance and muscular outcomes and genetic studies also support the hypothesis that the ACE system may be involved in physical performance and skeletal muscle function. Effects on the skeletal muscle are probably mediated by mechanical, metabolic, anti-inflammatory, nutritional, neurological and angiogenetic actions of these drugs. These studies may have major public health implications for older adults, as consequence of the fact that, in this population, gradual loss of muscle mass and muscle strength can play a key role in the onset and progression of disability. Therefore, if findings of observational studies will be later confirmed in randomized controlled trials, ACE inhibitors could represent an effective intervention to prevent physical decline in the elderly, leading to greater autonomy in this growing population.
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Ondera et al. (2006) conducted a review in Skeletal muscle decline in older adults and congestive heart failure. ACE inhibitors was evaluated. ACE inhibitors may improve skeletal muscle function and prevent physical decline in older adults, though these observational findings require confirmation in randomized controlled trials.
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