Angiotensin-Converting Enzyme Inhibitor Use and Incident Frailty in Women Aged 65 and Older: Prospective Findings from the Women's Health Initiative Observational Study

Authors

  • Shelly L. Gray PharmD, MS,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Andrea Z. LaCroix PhD,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Aaron K. Aragaki MS,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Mary McDermott MD,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Barbara B. Cochrane PhD, RN,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Charles L. Kooperberg PhD,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Anne M. Murray MD, MSc,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Beatriz Rodriguez MD, PhD,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Henry Black MD,

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Nancy F. Woods PhD

    1. From the *School of Pharmacy, University of Washington, Seattle, WashingtonWHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois§School of Nursing, University of Washington, Seattle, WashingtonChronic Disease Research Group, Hennepin County Medical Center, Minneapolis, Minnesota#Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, Hawaii**Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois††School of Nursing, University of Washington, Seattle, Washington.
    Search for more papers by this author

  • These data were presented in part at the Gerontological Society of America meeting, San Francisco, California, November 16–22, 2007.

Address correspondence to Shelly L. Gray, School of Pharmacy, University of Washington, Seattle, WA 98195. E-mail: slgray@u.washington.edu

Abstract

OBJECTIVES: To examine the associations between current use, duration, and potency of angiotensin-converting enzyme (ACE) inhibitors and incident frailty in women aged 65 and older who were not frail at baseline.

DESIGN: Data were from the Women's Health Initiative Observational Study (WHI-OS), a prospective study conducted at 40 U.S. clinical centers.

PARTICIPANTS: Women aged 65 to 79 at baseline who were not frail (N=27,378).

MEASUREMENTS: Current ACE inhibitor use was ascertained through direct inspection of medicine containers at baseline. Components of frailty were self-reported low physical function or impaired walking, exhaustion, low physical activity, and unintended weight. Frailty was ascertained through self-reported and physical measurements data at baseline and 3-year clinic contacts.

RESULTS: By the 3-year follow-up, 3,950 (14.4%) women had developed frailty. Current ACE inhibitor use had no association with incident frailty (multivariate adjusted odds ratio=0.96, 95% confidence interval=0.82–1.13). Duration and potency of ACE inhibitor use were also not significantly associated with incident frailty. A similar pattern of results was observed when incident cardiovascular disease events were studied as a separate outcome or when the sample was restricted to subjects with hypertension.

CONCLUSION: Overall, incidence of frailty was similar in current ACE inhibitor users and nonusers.

Ancillary