ACE inhibition and physical exercise: studies on physical work capacity, energy metabolism, and maximum oxygen uptake in well-trained, healthy subjects

We investigated the effects of the angiotensin-converting enzyme (ACE) inhibitor trandolapril (2 mg/o.d.) on the physical work capacity (PWC), the received perception of exertion (RPE), as well as parameters determining physical performance (i.e., energy metabolism, lactate production, and oxygen uptake) in well-trained, healthy subjects. Twenty male sports students underwent a bicycle spiroergometry until exhaustion to determine maximum work load, maximum oxygen uptake, lactate threshold, and parameters of energy metabolism. The identical protocol was repeated after a 14-day treatment period with 2 mg of trandolapril o.d. or placebo. Treatment with the ACE inhibitor did not significantly alter maximum PWC, RPE, 4.0 mmol/L lactate threshold, heart rate, maximum oxygen uptake, plasma levels of total cholesterol, triglycerides, free fatty acids, glucose, insulin, cortisol, and human growth hormone. In the presence of the ACE inhibitor, the exercise-induced increase in systolic blood pressure was moderately (n.s.) blunted (204 +/- 7 versus 192 +/- 7 mm Hg). Treatment with the ACE inhibitor did not impair physical performance and RPE. This favorable profile of action was accompanied by no alterations in maximum oxygen uptake and parameters of energy metabolism at all levels of exercise intensity. Therefore, it may be concluded that antihypertensive treatment with an ACE inhibitor should be primarily considered in physically active patients.