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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #331264
Title: Antihypertensive use and the effect of a physical activity intervention in the prevention of major mobility disability among older adults: The LIFE study

Author
item BUFORD, THOMAS - University Of Florida
item MILLER, MICHAEL - Wake Forest School Of Medicine
item CHURCH, TIMOTHY - Pennington Biomedical Research Center
item GILL, THOMAS - Yale School Of Medicine
item HENDERSON, REBECCA - Wake Forest School Of Medicine
item HSU, FANG-CHI - Wake Forest School Of Medicine
item MCDERMOTT, MARY - Northwestern University
item NADKARNI, NEELESH - University Of Pittsburgh
item PAHOR, MARCO - University Of Florida
item STAFFORD, RANDALL - Stanford School Of Medicine
item CARTER, CHRISTY - University Of Florida
item REID, KIERAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/17/2015
Publication Date: 2/10/2016
Citation: Buford, T.W., Miller, M.E., Church, T.S., Gill, T.M., Henderson, R., Hsu, F., Mcdermott, M.M., Nadkarni, N., Pahor, M., Stafford, R.S., Carter, C.S., Reid, K.F., Fielding, R.A. 2016. Antihypertensive use and the effect of a physical activity intervention in the prevention of major mobility disability among older adults: The LIFE study. Journal of Gerontology Medical Science. doi: 10.1093/gerona/glv222.

Interpretive Summary: This subgroup analysis of the Lifestyle Intervention and Independence for Elders (LIFE) trial evaluated the impact of a long-term physical activity (PA) intervention on development of the inability to walk among older adults according to their blood pressure medication use. LIFE 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. The effects of long-term PA on the incidence of inability to walk 400 meters was similar among three subgroups of older adults stratified by their blood pressure medication use. Several findings may warrant future study in other cohorts given the post hoc nature of this study.

Technical Abstract: BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.