title: Antihypertensive Use and the Effect of a Physical Activity Intervention in the Prevention of Major Mobility Disability Among Older Adults: The LIFE Study.
abstract: This subgroup analysis of the Lifestyle Intervention and Independence for Elders trial evaluates the impact of a long-term physical activity (PA) intervention on rates of major mobility disability (MMD) among older adults according to their antihypertensive medication use.
  
  
  
  Lifestyle Intervention and Independence for Elders study participants were randomized to center-based PA or health education for a median of 2.7 years. Participants were sedentary men and women aged 70-89 years with objectively measured physical limitations. This analysis evaluated rates of MMD and persistent MMD among 1,633 participants, according to antihypertensive medication use. Participants were designated as either (i) an angiotensin-converting enzyme (ACE) inhibitor user (ACEi+), (ii) a user of other antihypertensives not including ACEi (ACEi-), or (iii) nonusers of antihypertensive medications (AHT-). Interactions were explored between antihypertensive use and randomized arm.
  
  
  
  Interaction terms for MMD (p = .214) and persistent MMD (p = .180) did not reach statistical significance. For MMD, PA displayed marginal effects among ACEi+ (hazard ratio [HR] = 0.76; 95% confidence interval [CI] = 0.57, 1.02) and ACEi- (HR = 0.76; 95% CI = 0.60, 0.97) but not AHT- (HR = 1.19; 95% CI = 0.75, 1.87). For persistent MMD, the effect of PA was greatest among ACEi+ (HR = 0.57; 95% CI = 0.39, 0.84) when compared to ACEi- (HR = 0.76; 95% CI = 0.55, 1.06) or AHT- (HR = 1.18; 95% CI = 0.59, 2.36).
  
  
  
  The effects of long-term PA on the incidence of MMD and persistent MMD were similar among three subgroups of older adults stratified by their antihypertensive medication use. However, though statistical interactions did not reach significance, several findings may warrant future study in other cohorts given the post hoc nature of this study.
authors: Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville. tbuford@ufl.edu.
authors: Thomas W
authors: TW
authors: Buford
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Michael E
authors: ME
authors: Miller
authors: Preventive Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana.
authors: Timothy S
authors: TS
authors: Church
authors: Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors: Thomas M
authors: TM
authors: Gill
authors: Section on Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Rebecca
authors: R
authors: Henderson
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Fang-Chi
authors: FC
authors: Hsu
authors: Department of Medicine and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors: Mary M
authors: MM
authors: McDermott
authors: Department of Medicine, School of Medicine, University of Pittsburgh, Pennsylvania.
authors: Neelesh
authors: N
authors: Nadkarni
authors: Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville.
authors: Marco
authors: M
authors: Pahor
authors: Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California.
authors: Randall S
authors: RS
authors: Stafford
authors: Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville.
authors: Christy S
authors: CS
authors: Carter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004185:Disability Evaluation; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008019:Life Style; D008297:Male; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D013995:Time; D014481:United States
chemical_list: D000959:Antihypertensive Agents
keywords: Clinical trials; Exercise; Physical activity; Physical function