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

Objectives: 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. Design: Data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults, were used. Setting: Subjects were recruited from four U.S. sites beginning in 1989; this analysis included data through 2001. Participants: CHS participants with congestive heart failure (CHF) or treated hypertension. Measurements: 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. Results: 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. Conclusion: ACE inhibitor use may be associated with weight maintenance, but not maintenance of muscle strength, in older adults with treated hypertension.