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Paper of the day - ACE inhibition improves mobility

ACE-inhibitors may directly improve the exercise capacity and quality of life of elderly people with mobility problems but no heart failure, according to a study published today.

The double-blind, randomised study looked at the effects of perindopril in 130 people over 65 with mobility or functional impairment but no clinical diagnosis of heart failure. After 20 weeks, there was a mean difference of 31.4m in the distance that the perindopril-treated group could walk in 6 minutes, compared with the placebo group.

This improvement in exercise capacity with ACE inhibition is similair to the improvement seen after six months of exercise training. This may be due to an improvement in cardiac function, but also could be the result of a direct effect on muscle function, said the authors.

The increased mobility of the ACE-inhibitor treated participants was associated with a significant impact on quality of life. A decline in health-related quality of life was seen over time in the placebo group, but was maintained in the ACE-inhibitor treated group.

The authors said that the improvements in mobility and quality of life in this study should provide further encouragement for clinicians deliberating over the use of ACE inhibitors in elderly people for existing indications.

Canadian Medical Association Journal 2007;177(8):867-874

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