THURSDAY, March 14, 2002 (HealthDayNews) -- The ACE inhibitor drugs prescribed for high blood pressure and congestive heart failure have muscle-building powers that could help prevent disability in older people.
That's according to new research, which looked at 641 women whose average age was 79. Those who took ACE inhibitors during the three-year study had a significantly lower loss of muscle mass and physical function than those who didn't, says a report in the March 16 issue of The Lancet.
"This is one of the first studies to suggest that a drug treatment could delay a decline in physical function," says Dr. Graziano Onder, lead author and a research associate in the Sticht Center on Aging of Wake Forest University.
That effect could have both physical and financial benefits. Age-related decreases in walking ability and muscle strength are known to contribute to the need for nursing home or hospital care and to increase the risk of death.
The women in the study are participants in the long-running Women's Health and Aging Study, sponsored in part by the National Institute on Aging. They were all taking drugs to control blood pressure. All the women lost physical function as they grew older, but the losses were less for those who took ACE inhibitors continuously.
They lost an average of 1 kilogram (2.2 pounds) of muscle mass, compared to an average loss of 3.9 kilograms (8.5 pounds) for women who took other blood pressure drugs. The decline in walking speed was directly related to ACE inhibitor intake -- a loss of 1.7 centimeters per second for women who took ACE inhibitors continuously, a drop of 13.6 centimeters per second for those who took the drugs only part of the time, a decline of 15.7 centimeters per second for those who took other drugs.
It's not known exactly why the ACE inhibitors have that helpful effect, Onder says. The drugs act by blocking the activity of an enzyme that produces angiotensin II, which constricts blood vessels.
"There are indications that ACE inhibitors increase the uptake of glucose by muscles, as well as affecting the narrowing of blood vessels," he says.
There are tantalizing indications that the angiotensin-converting enzyme might play a role in general physical performance, says Dr. Richard Havlik, chief of the NIA's Laboratory of Epidemiology, Demography and Biometry. "There was a study a few years ago saying that successful mountain climbers and military recruits performed better depending on how much angiotensin-converting enzyme they have," he says.
Both Havlik and Onder say more work is needed to prove the beneficial effect of ACE inhibitors for the elderly.
"We would like to see another replication of it," Havlik says. "A study not necessarily of women, not necessarily of people with physical disability."
"If these results are confirmed in larger studies, they can have a tremendous effect on public health," Onder says. "Disability is a major issue for older adults, and that disability is probably related to the loss of muscle mass. If this drug can stop that progressive loss, it would be an impressive and important achievement."
No studies specifically targeting ACE inhibitors and muscle loss are planned, Havlik says. However, it might be possible to get supporting evidence from existing studies in which ACE inhibitors are prescribed for high blood pressure and congestive heart failure, he says.
What To Do
"We have to be conservative until there is some substantiation," Havlik says. "Until then, we better not encourage this use. But they are good drugs when used for the appropriate indication."
Information about loss of physical ability with age, and what can be done about it, is available from the National Institute on Aging. Read more about ACE inhibitors from the Texas Heart Institute.
