Angiotensin-Converting Enzyme Inhibitor and Statin Use and Incident Mobility Limitation in Community-Dwelling Older Adults: The Health, Aging and Body Composition Study

Authors

  • Shelly L. Gray PharmD, MS,

    Corresponding author
    • School of Pharmacy, University of Washington, Seattle, Washington
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  • Robert M. Boudreau PhD,

    1. Department of Epidemiology, School of Public Health
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  • Anne B. Newman MD, MPH,

    1. Department of Epidemiology, School of Public Health
    2. Division of Geriatrics, Department of Medicine, School of Medicine
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  • Stephanie A. Studenski MD, MPH,

    1. Division of Geriatrics, Department of Medicine, School of Medicine
    2. Center for Health Equity Research and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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  • Ronald I. Shorr MD, MPH,

    1. Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida
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  • Douglas C. Bauer MD,

    1. Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
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  • Eleanor M. Simonsick PhD,

    1. Intramural Research Program, National Institute on Aging, Baltimore, Maryland
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  • Joseph T. Hanlon PharmD, MS,

    1. Division of Geriatrics, Department of Medicine, School of Medicine
    2. Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh
    3. Center for Health Equity Research and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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  • for the Health, Aging and Body Composition Study


  • This work was presented in part at the 2009 American Geriatrics Society Annual Meeting, Chicago, Illinois.

Address correspondence to Shelly L. Gray, School of Pharmacy, University of Washington, Box 357630, Seattle, WA 98195. E-mail: slgray@u.washington.edu

Abstract

Objectives

To evaluate whether the use of angiotensin-converting enzyme (ACE) inhibitors and statins is associated with a lower risk of incident mobility limitation in older community dwelling adults.

Design

Longitudinal cohort study.

Setting

Health, Aging and Body Composition (Health ABC) study.

Participants

Three thousand fifty-five participants who were well functioning at baseline (no mobility limitations).

Measurements

Summated standardized daily doses (low, medium, high) and duration of ACE inhibitor and statin use were computed. Mobility limitation (two consecutive self-reports of having any difficulty walking one-quarter of a mile or climbing 10 steps without resting) was assessed every 6 months after baseline. Multivariable Cox proportional hazards analyses were conducted, adjusting for demographics, health status, and health behaviors.

Results

At baseline, 15.2% used ACE inhibitors and 12.9% used statins; use of both was greater than 25% by Year 6. Over 6.5 years of follow-up, 49.8% had developed mobility limitation. In separate multivariable models, neither ACE inhibitor (multivariate hazard ratio (HR) = 0.95, 95% confidence interval (CI) = 0.82–1.09) nor statin use (multivariate HR = 1.02, 95% CI = 0.87–1.17) was associated with lower risk of mobility limitation. Similar findings were seen in analyses examining dose–response and duration–response relationships and a sensitivity analysis restricted to those with hypertension.

Conclusion

ACE inhibitors and statins widely prescribed to treat hypertension and hypercholesterolemia, respectively, do not lower risk of mobility limitation, an important indicator of quality of life.

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