Effect of Angiotensin System Inhibitors on Physical Performance in Older People - A Systematic Review and Meta-Analysis.
Lorna Caulfield, Philip Heslop, Katherine E Walesby and 3 others
PMID 32859513WHAT IT FOUND
Across 8 trials of 952 older people, ACE inhibitors and ARBs did not improve strength, walking endurance, or physical performance.
Do not use these blood pressure medicines to enhance mobility or function.
Key findings
01Combining 6 endurance trials showed no significant effect on exercise capacity.
02Strength outcomes from 6 trials showed no significant beneficial treatment effect.
03The Short Physical Performance Battery showed no significant beneficial treatment effect.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Only 8 trials were included, and most were small, so the pooled estimate is not precise. Follow-up was mostly under 6 months, so longer-term effects were not assessed. No trial specifically recruited people diagnosed with sarcopenia, so the null result may not apply to that group. Different trials measured different physical tests, making it harder to combine results into one clear clinical number. Some trials had unclear randomization or allocation concealment. ARBs were studied in only 2 trials, so evidence for that class is limited.
The easy way to misread this
Do not stop an ACE inhibitor or ARB because it did not improve physical performance. These medicines remain indicated for blood pressure, cardiovascular risk, or heart failure.