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Effect of Angiotensin-Converting Enzyme Inhibitors on Physical Function in Elderly Subjects: A Systematic Review and Meta-Analysis

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Abstract

Background

Sarcopenia has been accepted as a new geriatric syndrome, which will become a common and important public health challenge. And angiotensin-converting enzyme inhibitors (ACEIs) have been shown to improve exercise capacity in elderly without heart failure.

Objectives

To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEIs) on physical function in elderly.

Data Sources

The Cochrane Library, PubMed, EMBASE and Web of Science were searched.

Eligibility Criteria

All researches included were randomized controlled trials (RCTs) which compared any kind of ACEIs with placebo or other anti-hypertensives in elderly, and provided empirical data of grip strength and 6-min walk distance change from baseline.

Study Appraisal and Synthesis Methods

Risk of bias was systematically assessed by using the Cochrane risk of bias tool. Data of grip strength and 6-min walk distance change from baseline were collected and mean differences (MDs) were calculated along with 95 % CI (confidence interval) by using a random effects model.

Results

In 3 RCTs including 337 elderly participants, ACEIs (n = 178) did not significantly improved 6-min walk distance (13.45, 95 % CI: −16.71 to 43.61; P = 0.38) versus placebo or other antihypertensives (n = 159). In 3 RCTs including 499 elderly participants, grip strength was not significantly different (−0.67, 95 % CI: −1.53 to 0.19; P = 0.12) between ACEIs (n = 260) and placebo or other antihypertensives (n = 239).

Limitations

There exists only 4 RCTs and the number of participants is limited. Pooling of data were from different trials including different participant characteristics. And intervention is not strictly consistent.

Conclusion

This study shows that ACEIs can not significantly improve walk distance or the age-related decline of muscle strength for older participants in clinical trials.

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Authors and Affiliations

  1. Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Ling-shan Zhou, Ling-jie Xu, Xue-qing Wang, Yi-huan Huang & Qian Xiao

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Correspondence to Qian Xiao.

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Conflict of interests

Our work was supported by grants from the National Key Clinical Specialties Construction Program of China (No. [2013]544). Ling-shan Zhou, Ling-jie Xu, Xue-qing Wang, Yi-huan Huang, Qian Xiao have no competing, conflicting interests to report.

Appendix

Appendix

1.1 Search strategy

(“Angiotensin-Converting Enzyme Inhibitors” OR “Angiotensin Converting Enzyme Inhibitors” OR ACEI OR “ACE inhibitors” OR “antihypertensive”) AND (“physical function” OR sarcopenia OR “exercise performance ” OR “gait speed” OR “muscle strength” OR “grip strength”) AND (“old people” OR elderly OR aged).

(“Angiotensin-Converting Enzyme Inhibitors”[Mesh]) AND (“physical function” OR sarcopenia OR “exercise performance” OR “gait speed” OR “muscle strength” OR “grip strength”) AND (“old people” OR elderly OR aged).

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Zhou, Ls., Xu, Lj., Wang, Xq. et al. Effect of Angiotensin-Converting Enzyme Inhibitors on Physical Function in Elderly Subjects: A Systematic Review and Meta-Analysis. Drugs Aging 32, 727–735 (2015). https://doi.org/10.1007/s40266-015-0288-3

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