Angiotensin-Converting Enzyme Inhibitor and Statin Use and Incident Mobility Limitation in Community-Dwelling Older Adults:: The Health, Aging and Body Composition Study

• Autores: Shelly L. Gray, Robert M. Boudreau, Anne B. Newman, Stephanie A. Studenski, Ronald I. Shorr, Douglas C. Bauer, Eleanor M. Simonsick, Joseph T. Hanlon
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 59, Nº. 12, 2011, págs. 2226-2232
• Idioma: inglés
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• Resumen

  • Objectives: To evaluate whether the use of angiotensin-converting enzyme (ACE) inhibitors and statins is associated with a lower risk of incident mobility limitation in older community dwelling adults.

    Design: Longitudinal cohort study.

    Setting: Health, Aging and Body Composition (Health ABC) study.

    Participants: Three thousand fifty-five participants who were well functioning at baseline (no mobility limitations).

    Measurements: Summated standardized daily doses (low, medium, high) and duration of ACE inhibitor and statin use were computed. Mobility limitation (two consecutive self-reports of having any difficulty walking one-quarter of a mile or climbing 10 steps without resting) was assessed every 6 months after baseline. Multivariable Cox proportional hazards analyses were conducted, adjusting for demographics, health status, and health behaviors.

    Results: At baseline, 15.2% used ACE inhibitors and 12.9% used statins; use of both was greater than 25% by Year 6. Over 6.5 years of follow-up, 49.8% had developed mobility limitation. In separate multivariable models, neither ACE inhibitor (multivariate hazard ratio (HR) = 0.95, 95% confidence interval (CI) = 0.82�1.09) nor statin use (multivariate HR = 1.02, 95% CI = 0.87�1.17) was associated with lower risk of mobility limitation. Similar findings were seen in analyses examining dose�response and duration�response relationships and a sensitivity analysis restricted to those with hypertension.

    Conclusion: ACE inhibitors and statins widely prescribed to treat hypertension and hypercholesterolemia, respectively, do not lower risk of mobility limitation, an important indicator of quality of life.