Associations between ACE-Inhibitors, Angiotensin Receptor Blockers, and Lean Body Mass in Community Dwelling Older Women.

Jennifer W Bea,Zhao Chen,Yann Klimentidis,Candyce H Kroenke,Andrea Z Lacroix,Todd M Manini,Sylvia Wassertheil-Smoller,Oleg Zaslavsky,Cynthia A Thomson,Betsy C Wertheim,Catherine R Womack

doi:10.1155/2018/8491092

Abstract

Studies suggest that ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) may preserve skeletal muscle with aging. We evaluated longitudinal differences in lean body mass (LBM) among women diagnosed with hypertension and classified as ACE-I/ARB users and nonusers among Women's Health Initiative participants that received dual energy X-ray absorptiometry scans to estimate body composition (n=10,635) at baseline and at years 3 and 6 of follow-up. Of those, 2642 were treated for hypertension at baseline. Multivariate linear regression models, adjusted for relevant demographics, behaviors, and medications, assessed ACE-I/ARB use/nonuse and LBM associations at baseline, as well as change in LBM over 3 and 6 years. Although BMI did not differ by ACE-I/ARB use, LBM (%) was significantly higher in ACE-I/ARB users versus nonusers at baseline (52.2% versus 51.3%, resp., p=0.001). There was no association between ACE-I/ARB usage and change in LBM over time. Reasons for higher LBM with ACE-I/ARB use cross sectionally, but not longitundinally, are unclear and may reflect a threshold effect of these medications on LBM that is attenuated over time. Nevertheless, ACE-I/ARB use does not appear to negatively impact LBM in the long term.

Highlights

Sarcopenia, defined as a progressive loss of skeletal muscle mass, is a significant public health concern linked to diminished quality of life, disability, and even mortality in older adults [1, 2]
Within older populations, antihypertensive medications, such as ACE-inhibitors (ACE-I) and angiotensin receptor Journal of Aging Research blockers (ARBs), are regularly prescribed to those at risk for or diagnosed with hypertension and cardiovascular diseases (CVDs) [3]. These medications target angiotensin II, a protein upregulated in hypertension and CVD, which has been associated with a phenomenon called cardiac cachexia, in which the skeletal muscle mass is lost more rapidly than would be expected under normal aging conditions [4]. us, ACE-I and ARBs, respectively, may help to preserve lean body mass (LBM) among older adults
Total body lean mass was significantly greater among ACE-I/ARB users compared to nonusers in fully adjusted models at baseline (Table 2; lean mass, kg: β: 0.42; standard error (SE): 0.20; p < 0.04). e absolute lean mass association with ACE-I/ARB use stratified by Body mass index (BMI) (normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30 kg/m2)) remained significant for normal weight (0.77 (0.28); p 0.007) and overweight (0.67 (0.22); p 0.002) categories, but not for obese women (0.14 (0.28); p 0.621)

Summary

Introduction

Sarcopenia, defined as a progressive loss of skeletal muscle mass, is a significant public health concern linked to diminished quality of life, disability, and even mortality in older adults [1, 2]. Journal of Aging Research blockers (ARBs), are regularly prescribed to those at risk for or diagnosed with hypertension and cardiovascular diseases (CVDs) [3] These medications target angiotensin II, a protein upregulated in hypertension and CVD, which has been associated with a phenomenon called cardiac cachexia, in which the skeletal muscle mass is lost more rapidly than would be expected under normal aging conditions [4]. Us, ACE-I and ARBs, respectively, may help to preserve lean body mass (LBM) among older adults Studies suggest that these medications target smooth muscle relaxation, aiding in blood pressure control, and have a direct positive effect on skeletal muscle [2, 4, 5]. Hypertension, commonly treated with ACE-I/ARBs, is present in 34% of US adults aged 45–64 years [11]

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Conclusion