Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.
Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.
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DOI：
10.14283/jfa.2023.10
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发表时间：
2023
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关于血管紧张素转换酶抑制剂和身体功能的作用存在相互矛盾的证据。虽然一些研究显示肌肉力量和身体功能有所改善，但其他研究则显示没有显着差异或表现下降。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所致，根据其穿过血脑屏障的能力，可以将其分为中枢作用或外周作用。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：流动 参与者：在健康与退休研究队列中 364 名年龄≥ 65 岁的参与者中进行（中位年龄 (IQR) 74.00 (69-80) 岁）。测量：握力 (kg)、步态速度 (m/s) 和呼气峰值流量 (L/min) 的平均差异。与使用外周作用血管紧张素转换酶抑制剂的参与者相比(113 (31%)) 中，使用中枢作用药物的患者 (251(69%)) 具有更强的握力（28.9 ±1.0 vs 26.3±1.0，p=.011）和更高的峰值呼气流速（316.8±130.4 vs. 280.0±118.5，p= 0.011），在未经调整的分析中，经过多次调整后，PEF 的差异仍然具有统计学意义。显着（估计（CI）26.5，95% CI 2.24，50.5，p = 0.032）我们的结果表明，与外周作用血管紧张素转换酶抑制剂相比，在老年人中使用中枢作用血管紧张素转换酶抑制剂与老年人更好的肺功能相关。
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. The objective of this study is to compare physical performance measures among angiotensin-converting enzyme inhibitor subtype users. 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). 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). 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.