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Scottish Executive Health Department Chief Scientist Office
A DOUBLE BLIND PLACEBO CONTROLLED TRIAL OF THE EFFECT OF PERINDOPRIL ON MUSCLE STRENGTH
AND PHYSICAL FUNCTION IN OLDER PEOPLE
Most participants adhered to the medication for most
Dr D Sumukadas, Dr M D Witham, Professor A D of the time. The medication was well tolerated and Struthers, Professor M E T McMurdo
To determine if the ACE inhibitor Perindopril would Perindopril can maintain and improve muscle
improve muscle strength and physical function in function, especially exercise capacity, in older people older people without heart failure. ACE inhibitors are without heart failure.
a family of drugs used to treat high blood pressure or heart failure
What does this study add to the field?
With ageing, muscle function deteriorates and is a
major cause of disability in later life. Until now
A double blind placebo controlled randomized clinical exercise has been the mainstay of treatment to trial carried out at the Section of Ageing & Health in improve muscle function in old age. However many
the University of Dundee. Patients aged 65 years and older people are unable or unwilling to exercise. ACE over with difficulties in mobility or activities of daily inhibitors are commonly used in patients with heart
living were recruited. We excluded those with heart failure and we have previously shown that in older failure, already taking ACE inhibitors, with heart failure patients, Perindopril increases the 6 contraindications to ACE inhibitors, unable to do the minute walking distance. The current study shows
tests and those unable to provide consent. that ACE inhibitors can also improve physical function Participants were randomized to receive either in older people without heart failure. This implies that
Perindopril or placebo for 20 weeks. Outcomes were the drug has a local action on muscles apart from measured at baseline, 10 and 20 weeks. The main heart failure.
outcome measure was a change in the distance
walked over 6 minutes. We also tested the time Implications for Practice or Policy
taken to stand from a chair 10 times and the time ACE inhibitors are commonly used medications taken to get up from a chair, walk 3 metres and preventing cardiovascular morbidity and mortality. return to the chair. Self reported changes in Our study shows that these medicines can
activities of daily living and quality of life were additionally benefit muscle function and may lead to measured using standard questionnaires. Daily decreased disablity in older people and maintainance
activity levels were measured also over a 7 day of functional independence. period. Blood tests ensured the medication was
tolerated. Tablets were counted to verify adherence Where to next?
Our findings suggest a gradual improvement in
muscle function over time. Studies with longer follow
up periods will determine the magnitude of the
Ninety five patients completed the study. After 20 improvement that can be achieved with ACE weeks patients on Perindopril increased their 6 inhibition.
minute walking distance by 31.4 metres while those
on placebo worsened. This improvement is Further details from:
comparable to that seen after 6 to 12 months of Dr Deepa Sumukadas exercise in older people. Patients on Perindopril also Ageing & Health
maintained their quality of life while those on placebo Division of Medicine and Therapeutics reported a worsening of quality of life. Daily activity University of Dundee
Chief Scientist Office, St Andrews House, Regent Road, Edinburgh, EH1 3DG Tel:0131 244 2248
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