ACE and ARB medicines effects on physical performance

[franklie]

This link Effect of Angiotensin System Inhibitors on Physical Performance in Older People – A Systematic Review and Meta-Analysis - ScienceDirect seems to indicate that ACE & ARB medicines used to reduce high blood pressure may help reduce muscle loss in older adults.

When I read this article is seems to indicate that ACE and ARB medicines can help with retaining muscle in the elderly.

More recently, a number of biological mechanisms have been elucidated by which these drugs might improve peripheral skeletal muscle function.9 Angiotensin II has direct deleterious effects on skeletal muscle structure and function in experimental conditions10,11 and may impair both macrovascular and microvascular endothelial function, and hence, blood flow in peripheral vascular beds.12 Angiotensin II also promotes chronic inflammation,13 which is in turn thought to be an important driver of sarcopenia—the age-related loss of muscle mass and strength that underpins impaired physical performance in many older people. Conversely use of ACEi and ARBs can ameliorate these deleterious effects in experimental conditions;

Am I reading the article wrong?

[Mark Rippetoe]

Our pharmacologist is unavailable right now. But you already know that "peer-reviewed literature" is phenomenally shitty. These are some of the most highly-prescribed medications in the country, and I have not noticed an increase in physical performance in the demographic typically associated with blood pressure medication. Have you? ACE inhibitors are not a substitute for Dianabol, if that's what you're thinking.

[JFord]

This link Effect of Angiotensin System Inhibitors on Physical Performance in Older People – A Systematic Review and Meta-Analysis - ScienceDirect seems to indicate that ACE & ARB medicines used to reduce high blood pressure may help reduce muscle loss in older adults.

When I read this article is seems to indicate that ACE and ARB medicines can help with retaining muscle in the elderly.

Am I reading the article wrong?

You seem to at least be reading that quote correctly, but so what? Do you think this article by itself provides enough evidence of benefit in preventing muscle-wasting to make a formal recommendation of using these classes of drugs with all elderly or other patients at risk of muscle-wasting? Just be glad that the study didn’t show that they worsened muscle-wasting.

I for one will continue to use these drugs to prevent ventricular remodeling in the setting of myocardial infarct and CHF, for treating hypertension in diabetics and other patient populations, and for slowing the acceleration of kidney dysfunction in those experiencing it. These are all conditions for which there is good evidence of improved outcomes.

Fun thought experiment! Ask yourself how surprised you’d be to discover that this study was funded by a company that produced an ACEI or an ARB.

[franklie]

To both Coach Rip and jford,

I expressed myself badly in what I wrote. What I was trying to ask is, are ACE inhibitors and ARB medicines the best/safest medications for those with high blood pressure who wish to train with weights and get stronger?

To contrast, many doctors prescribe statins for those with high cholesterol but there seems to be an increased risk for soft tissue tears for those who lift weights.

I have several friends who would like to train with me who are hypertensive and are on medications to reduce it. Their motivations for lifting are to ameliorate the chronic lower back pain that they have. Like me they are in their 6th decade of living. They have heard how I improved my back health through lifting weights and seen me physically moving like a much younger man. Deadlifts, squats and press have been the principal exercises in creating this change and the correct form and running through the Starting Strength program were fundamental as well.

The Starting Strength forums have become one of the best places to learn about lifting and health especially for those of us in the senior set.

[Marc Brainich]

You and your friends might find Chapter 5 of Malcolm Kendrick’s Doctoring Data useful on this topic. I don’t recall if Dr. Kendrick addressed high blood pressure in any of the podcasts with him.

My doctor wanted to prescribe BP lowering medication at 140/90. Same doc who said T at 316 was “fine,” and statins at 250 chol.

I’ve gotten to the point where I believe if all of modern medicine except public health measures, anesthesia, and accident surgery disappeared, it’d be a wash.

If nothing else, reading Dr. Kendrick’s books will help get your friends to where you are right now - realizing that the days of blindly following doctor’s orders are long since gone.

[Buffaloguy]

" Summary of evidence: our systematic review found no evicence of efficacy for aceI or ARB in improving either strength or endurance measures of physical performance in older people."

With that said these meds are fine if you need them. I would take an ARB over an AceI personally due to the ACEi risk or angioedema, which can be life threatening.