Related Experiment Video
Updated: Dec 10, 2025
12:59
Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People
Published on: July 5, 2017
12.9K
Effect of Angiotensin System Inhibitors on Physical Performance in Older People - A Systematic Review and
Lorna Caulfield1, Philip Heslop1, Katherine E Walesby2
1AGE Research Group, NIHR Newcastle Biomedical Research Center, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Journal of the American Medical Directors Association
|August 30, 2020
Summary
This systematic review found no significant improvement in physical performance for older adults using angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs). Current evidence does not support their use as a standalone treatment for enhancing strength or endurance in this population.
Area of Science:
- Gerontology
- Pharmacology
- Exercise Physiology
Background:
- Preclinical and observational studies suggest ACE inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may enhance skeletal muscle function.
- These medications could potentially improve physical performance in older individuals through direct and indirect mechanisms.
- However, robust clinical evidence from randomized controlled trials (RCTs) is needed to confirm these effects.
Purpose of the Study:
- To systematically review and meta-analyze RCTs evaluating the efficacy of ACEi and ARBs on physical performance in older adults.
- To summarize the current evidence regarding the impact of these drugs on measures of endurance and strength.
Main Methods:
- A systematic literature search was conducted across multiple databases up to February 2020.
- Included RCTs enrolled participants aged 65 years or older, comparing ACEi or ARBs against placebo, usual care, or other antihypertensives.
- Data on endurance, strength, and the Short Physical Performance Battery were extracted, and standardized mean differences (SMDs) were calculated using random-effects models.
Main Results:
- Eight RCTs involving 952 participants were included in the meta-analysis.
- No significant improvements were observed in endurance (SMD 0.04, 95% CI -0.22 to 0.29) or strength (SMD -0.02, 95% CI -0.18 to 0.14).
- The Short Physical Performance Battery also showed no significant change (SMD -0.04, 95% CI -0.19 to 0.11).
Conclusions:
- The current body of evidence does not support the use of ACE inhibitors or ARBs as a single intervention to improve physical performance in older people.
- Further research may be needed to explore potential benefits in specific subgroups or in combination with other interventions.
- The findings highlight the need for evidence-based strategies to maintain physical function in aging populations.
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
743
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
743
01:25Antihypertensive Drugs: Direct Renin Inhibitors
1.1K
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.1K
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
2.1K
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
2.1K
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
121
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
121
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
115
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
115
01:15Drug Dosing: Geriatric Patients
141
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
141