title: Angiotensin-converting enzyme inhibitor and statin use and incident mobility limitation in community-dwelling older adults: the Health, Aging and Body Composition study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Health, Aging and Body Composition (Health ABC) study.
  
  
  METHODS
  Three thousand fifty-five participants who were well functioning at baseline (no mobility limitations).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Pharmacy, University of Washington, Seattle, Washington 98195, USA. slgray@u.washington.edu
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Robert M
authors.initials: RM
authors.lastname: Boudreau
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Studenski
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D012111:Residence Characteristics; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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