Antihypertensive medications and differences in muscle mass in older persons: the Health, Aging and Body Composition Study

J Am Geriatr Soc. 2004 Jun;52(6):961-6. doi: 10.1111/j.1532-5415.2004.52265.x.


Objectives: To evaluate whether older persons using angiotensin-converting enzyme (ACE) inhibitors have a larger lower extremity muscle mass (LEMM) than users of other antihypertensive drugs.

Design: Cross-sectional analysis of data from the Health, Aging and Body Composition (Health ABC) Study.

Setting: University of Tennessee, Memphis, and University of Pittsburgh clinics.

Participants: A community-based sample of 2,431 well functioning participants of the Health ABC, aged 70 to 79, who were free of heart failure, were selected according to use of antihypertensive medications: ACE inhibitors (n=197), beta-blockers (n=169), thiazides (n=216), calcium-channel blockers (n=340), or none (n=1,509).

Measurements: LEMM, assessed using dual-energy x-ray absorptiometry, compared by index drug in analysis of variance models unadjusted and adjusted for demographics, study site, height, body fat, physical activity, blood pressure, coronary artery disease, diabetes mellitus, and chronic pulmonary disease.

Results: LEMM significantly differed across the study groups, being larger in users of ACE inhibitors than in users of other drugs (unadjusted and adjusted models). LEMM was comparable in users of ACE inhibitors and no drug users. A trend toward larger LEMM was also observed in sex- and ethnicity-stratified analyses and in the subgroup of noncoronary hypertensive participants.

Conclusion: In older persons, use of ACE inhibitors is associated cross-sectionally with larger LEMM. This finding suggests a possible explanation of the benefits of ACE inhibitors in wasting syndromes. If confirmed in longitudinal studies, this pharmacological action might have important implications for the prevention of physical disability in older patients with hypertension.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • African Americans
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use*
  • Benzothiadiazines
  • Body Mass Index
  • Calcium Channel Blockers / therapeutic use
  • Cross-Sectional Studies
  • Diuretics
  • Female
  • Health Surveys
  • Humans
  • Leg*
  • Male
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / drug effects*
  • Sodium Chloride Symporter Inhibitors / therapeutic use
  • Whites


  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Benzothiadiazines
  • Calcium Channel Blockers
  • Diuretics
  • Sodium Chloride Symporter Inhibitors