Schellenbaum Gina D, Smith Nicholas L, Heckbert Susan R, Lumley Thomas, Rea Thomas D, Furberg Curt D, Lyles Mary F, Psaty Bruce M
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
J Am Geriatr Soc. 2005 Nov;53(11):1996-2000. doi: 10.1111/j.1532-5415.2005.53568.x.
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.
确定使用血管紧张素转换酶（ACE）抑制剂是否与老年人的体重维持及持续肌肉力量（通过握力测量）有关。
使用心血管健康研究（CHS）的数据，这是一项针对5888名老年人的基于社区的前瞻性队列研究。
从1989年开始在美国四个地点招募受试者；该分析纳入了截至2001年的数据。
患有充血性心力衰竭（CHF）或接受治疗的高血压的CHS参与者。
通过每年门诊就诊时的药物清单确定暴露因素，即当前是否使用ACE抑制剂；结果指标为次年的体重变化和握力变化。采用多变量线性回归分析，考虑同一参与者不同时间观察结果之间的相关性。
2834名接受治疗的高血压参与者（14443人年）的平均年体重变化为-0.38kg，342名CHF参与者（980人年）的平均年体重变化为-0.62kg。在调整潜在混杂因素后，使用ACE抑制剂与较少的年体重减轻相关：接受治疗的高血压患者中差异为0.17kg（95%置信区间（CI）=0.05-0.29），CHF患者中差异为0.29kg（95%CI=-0.25-0.83）。没有证据表明使用ACE抑制剂与握力变化之间存在关联。
在接受治疗的高血压老年人中，使用ACE抑制剂可能与体重维持有关，但与肌肉力量维持无关。
