Background

To further inform benefits and risks of medications on physical function in aging populations, we have evaluated the associations of antihypertensive (antiHTN) class and number used with skeletal muscle function, mobility, sedentary time, and symptoms in older persons.

Methods

Using baseline data from the Lifestyle Interventions and Independence in Elder (LIFE) study (N = 1567, mean age 78.9 years) and multivariable models, we evaluated cross-sectional associations of antiHTN class and number used with physical measures and symptom questionnaires. AntiHTN class included diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB), and beta blockers (BB). Physical measures included respiratory muscle weakness (maximal inspiratory pressure), grip weakness (dynamometer), impaired lower extremity proximal muscle strength (chair stands), impaired balance (three-stage test), slow gait (400 m walk), mobility impairment (Short Physical Performance Battery), and high sedentary time (accelerometry). Symptoms included dyspnea and fatigue. Covariates included clinical characteristics and non-antiHTNs.

Results

Use of any antiHTN was highly prevalent (n = 1248 [79.6%]). In the antiHTN subgroup, each antiHTN class was well represented (ranging 36.6%–62.7%) and included use of three or more antiHTNs (32.0%). In adjusted models, the only statistically significant associations were use of BB and three or more antiHTNs with high sedentary time: odds ratios (95% confidence intervals) 1.44 (1.12, 1.85) and 1.52 (1.04, 2.23), respectively.

Conclusion

Use of BB and three or more antiHTNs yielded 44% and 52% increased odds of accelerometry-defined high sedentary time, respectively. Notably, high sedentary time is a risk factor for adverse health outcomes. Thus, future work should evaluate whether high sedentary time mitigates benefits or increases risks, regarding antiHTN use in aging populations.

中文翻译：

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老年人的抗高血压药物和身体功能。

 背景

为了进一步了解药物对老年人群身体功能的益处和风险，我们评估了抗高血压药物 (antiHTN) 的类别和数量与老年人骨骼肌功能、活动能力、久坐时间和症状的关联。

 方法

使用老年人生活方式干预和独立性 (LIFE) 研究（ N = 1567，平均年龄 78.9 岁）的基线数据和多变量模型，我们评估了抗 HTN 类别和数量与身体测量和症状问卷的横断面关联。抗HTN类包括利尿剂、血管紧张素转换酶抑制剂（ACEi）、血管紧张素受体阻滞剂（ARB）、钙通道阻滞剂（CCB）和β阻滞剂（BB）。物理测量包括呼吸肌无力（最大吸气压力）、握力无力（测力计）、下肢近端肌肉力量受损（椅子站立）、平衡受损（三阶段测试）、步态缓慢（400 m 步行）、活动障碍（短距离步行）物理性能（电池）和高久坐时间（加速度测量）。症状包括呼吸困难和疲劳。协变量包括临床特征和非抗HTN。

 结果

任何抗 HTN 的使用都非常普遍 ( n = 1248 [79.6%])。在抗HTN亚组中，每种抗HTN类别都有很好的代表性（范围为36.6%–62.7%），并且包括使用三种或更多抗HTN（32.0%）。在调整后的模型中，唯一具有统计学意义的关联是使用 BB 和三种或多种抗 HTN 且久坐时间长：比值比（95% 置信区间）分别为 1.44 (1.12, 1.85) 和 1.52 (1.04, 2.23)。

 结论

使用 BB 和三种或更多抗 HTN 可使加速测量定义的久坐时间长的几率分别增加 44% 和 52%。值得注意的是，久坐时间长是造成不良健康结果的风险因素。因此，未来的工作应该评估在老龄化人群中使用抗HTN药物时，久坐时间是否会减轻益处或增加风险。