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Related Concept Videos

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

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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...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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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...
479
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

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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,...
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Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

796
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
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Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Updated: Aug 6, 2025

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People
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Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.

C J George1, C B Hall, E F Weiss

  • 1Claudene George MD, MS, RPh, Division of Geriatrics 111 East 210th Street, Bronx, NY 10467, Tel: 718-920-6722, Fax: 718-655-9672,

The Journal of Frailty & Aging
|March 22, 2023
PubMed
Summary

Centrally-acting angiotensin-converting enzyme inhibitors were linked to better lung function in older adults compared to peripherally-acting agents. This study investigated ACE inhibitor subtypes and their impact on physical performance in seniors.

Keywords:
Angiotensin-converting enzyme inhibitorsaginggaitgrip strengthpeak flow

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Area of Science:

  • Gerontology
  • Pharmacology
  • Physiology

Background:

  • Conflicting evidence exists on angiotensin-converting enzyme inhibitors (ACEi) and physical function.
  • ACEi subtypes (central vs. peripheral) may explain differential effects on physical performance.
  • Understanding these differences is crucial for optimizing treatment in older adults.

Purpose of the Study:

  • To compare physical performance measures between users of centrally-acting and peripherally-acting ACE inhibitors.
  • To investigate the association between ACE inhibitor subtypes and physical function in older adults.
  • To clarify the role of ACEi in maintaining physical capacity in the elderly.

Main Methods:

  • Cross-sectional study of 364 participants aged 65+ from the Health and Retirement Study.
  • Compared hand grip strength, gait speed, and peak expiratory flow (PEF) between ACE inhibitor users.
  • Utilized unadjusted and multiple adjusted analyses to assess differences.

Main Results:

  • Participants on centrally-acting ACE inhibitors (69%) showed significantly stronger grip strength (28.9 vs. 26.3 kg, p=.011) compared to those on peripherally-acting agents (31%).
  • Centrally-acting ACE inhibitor users also exhibited higher PEF rates (316.8 vs. 280.0 L/min, p=.011) in unadjusted analysis.
  • The difference in PEF remained statistically significant after multiple adjustments (Estimate(CI) 26.5, 95% CI 2.24, 50.5, p=0.032).

Conclusions:

  • Centrally-acting ACE inhibitors are associated with better lung function in older adults compared to peripherally-acting ACE inhibitors.
  • Findings suggest a potential benefit of central ACE inhibitors for respiratory health in the elderly.
  • Further research is warranted to confirm these associations and explore underlying mechanisms.