Weight Loss, Muscle Strength, and Angiotensin‐Converting Enzyme Inhibitors in Older Adults with Congestive Heart Failure or Hypertension

Abstract

To determine whether angiotensin-converting enzyme (ACE) inhibitor use may be associated with weight maintenance and sustained muscle strength (measured by grip strength) in older adults. Data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults, were used. Subjects were recruited from four U.S. sites beginning in 1989; this analysis included data through 2001. CHS participants with congestive heart failure (CHF) or treated hypertension. The exposure, current ACE inhibitor use, was ascertained by medication inventory at annual clinic visits; the outcomes were weight change and grip-strength change during the following year. Multivariate linear regression was used, accounting for correlations between observations on the same participant over time. The average annual weight change was -0.38 kg in 2,834 participants (14,443 person-years) with treated hypertension and -0.62 kg in 342 participants (980 person-years) with CHF. ACE inhibitor use was associated with less annual weight loss after adjustment for potential confounders: a difference of 0.17 kg (95% confidence interval (CI)=0.05-0.29) in those with treated hypertension and 0.29 kg (95% CI=-0.25-0.83) in those with CHF. There was no evidence of association between ACE inhibitor use and grip-strength change. ACE inhibitor use may be associated with weight maintenance, but not maintenance of muscle strength, in older adults with treated hypertension.