The effects of antihypertensive medications on physical function

OBJECTIVE Limited research has examined the effects of antihypertensive medication use and physical function. These studies provided mixed findings while employing a convenience sample and limiting their examination to few indices of physical function and few classes of antihypertensive medications. The purpose of this study was to examine whether several antihypertensive medication classes were associated with several measures of physical function in a national sample of U.S. middle-to-older age adults. METHODS Data from the 1999-2002 and 2011-2012 NHANES were used. Antihypertensive medication use was assessed from an interviewer, and included angiotensin converting enzyme (ACE) inhibitors, peripherally-acting antiadrenergic agents and centrally-acting antiadrenergic agents. Physical function-related parameters included objectively-measured lower extremity isokinetic knee extensor strength (IKES), objectively-measured grip strength, laboratory-assessed walking performance (8 and 20 ft walk tests) and self-reported physical activity engagement. RESULTS Those on ACE inhibitors had a 37% reduced odds (OR = 0.63, 95% CI: 0.48-0.83, P = .002) of engaging in moderate-to-vigorous physical activity, had reduced knee extensor strength (β = - 15.4, 95% CI: - 27.2 to - 3.4, P = .01) and took longer to complete the 20 ft (β = .42, 95% CI: 0.02-0.81, P = .04) and 8 ft walking tests (β = .22, 95% CI: 0.05-0.39, P = .01). Those on peripherally-acting antiadrenergic agents had reduced grip strength (β = - 4.8, 95% CI: - 9.1 to - 0.5, P = .02). CONCLUSIONS Antihypertensive medication use, particularly ACE inhibitors, is associated with various measures of reduced physical function. Clinicians are encouraged to monitor the long-term mobility function of their patients on antihypertensive medications.