Department of Medicine for the Elderly, NHS Tayside, Dundee, UK.
Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK.
Age Ageing. 2018 Jan 1;47(1):75-81. doi: 10.1093/ageing/afx127.
double-blind, parallel group, placebo-controlled randomised trial.
we recruited people aged >65 years with at least one fall in the previous year. Participants received 4 mg perindopril or placebo daily for 15 weeks. The primary outcome was the between-group difference in force-plate measured anteroposterior (AP) sway at 15 weeks. Secondary outcomes included other measures of postural sway, limits of stability during maximal forward, right and left leaning, blood pressure, muscle strength, 6-min walk distance and falls. The primary outcome was assessed using two-way ANOVA, adjusted for baseline factors.
we randomised 80 participants. Mean age was 78.0 (SD 7.4) years; 60 (75%) were female. About 77/80 (96%) completed the trial. At 15 weeks there were no significant between-group differences in AP sway with eyes open (mean difference 0 mm, 95% CI -8 to 7 mm, P = 0.91) or eyes closed (mean difference 2 mm, 95% CI -7 to 12 mm, P = 0.59); no differences in other measures of postural stability, muscle strength or function. About 16/40 (42%) of patients in each group had orthostatic hypotension at follow-up. The median number (IQR) of falls was 1 (0,4) in the perindopril versus 1 (0,2) in the placebo group (P = 0.24).
perindopril did not improve postural sway in older people at risk of falls.
ISRCTN58995463.
双盲、平行组、安慰剂对照随机试验。
我们招募了年龄在 65 岁以上且在前一年至少跌倒过一次的患者。参与者每天接受 4 毫克培哚普利或安慰剂治疗 15 周。主要结局是 15 周时力板测量的前后（AP）摆动的组间差异。次要结局包括其他姿势摆动测量、最大向前、向右和向左倾斜时的稳定性极限、血压、肌肉力量、6 分钟步行距离和跌倒。主要结局采用双向方差分析进行评估，并根据基线因素进行调整。
我们随机分配了 80 名参与者。平均年龄为 78.0（SD 7.4）岁；60 名（75%）为女性。大约 77/80（96%）完成了试验。在 15 周时，睁眼时 AP 摆动（平均差异 0 毫米，95%CI-8 至 7 毫米，P=0.91）或闭眼时（平均差异 2 毫米，95%CI-7 至 12 毫米，P=0.59）两组间无显著差异；其他姿势稳定性、肌肉力量或功能测量也无差异。随访时，每组约有 16/40（42%）的患者出现体位性低血压。培哚普利组（中位数（IQR）为 1（0，4））和安慰剂组（中位数（IQR）为 1（0，2））的跌倒中位数（IQR）（P=0.24）。
培哚普利不能改善有跌倒风险的老年人的姿势摆动。
ISRCTN58995463。
