Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: a randomized controlled trial. Journal of the American Medical Association 2013; 309: 453-460

Effect of Antihypertensive and Statin Medication Use on Muscle Performance in Community-Dwelling Older Adults Performing Strength Training

OBJECTIVES

Antihypertensive drugs (AHTD) and statins have been shown to have effects beyond their primarily designed purpose; here we investigate their possible effect on muscle performance and strength in older adults following a physical exercise programme.

DESIGN

The Senior PRoject INtensive Training (SPRINT) study is a randomised, controlled clinical trial designed to evaluate the effects of physical exercise on the immune system and muscle performance in older adults.

PARTICIPANTS

In this secondary analysis, we included 179 independent participants (aged 65 years and above). We applied further categorisation based on medication use: AHTD (including, angiotensin-converting enzyme inhibitors [ACEI], angiotensin II receptor blockers [ARB], β-blockers, and other AHTD) and statins.

INTERVENTION

Participants were allocated randomly to one of the three exercise protocols: intensive strength training 3 times/week (3 × 10 repetitions at 80% of one-repetition maximum), strength endurance training (2 × 30 repetitions at 40% of one-repetition maximum), or control (passive stretching exercise) for 6 weeks.

MEASUREMENTS

The change in maximal hand grip strength (GS), muscle fatigue resistance (FR), Muscle Strength Index (MSI), the 6-min walk test (6MWT), and Timed Up and Go Test (TUG) were assessed before and after 6 weeks of training.

RESULTS

After 6 weeks, muscle strength (MSI and TUG) improved significantly in all training groups compared to baseline, independently of AHTD use. Moreover, AHTD had no effect on exercise improvements, with no significant differences between medication groups, except for TUG in ARB users, which exhibited a significantly lower performance. On the other hand, statin users presented a significantly longer FR time, indicating better performance compared to non-users. Finally, medication did not affect the participants' commitment to the training programme.

CONCLUSION

Our study showed that statins and ARB usage might affect participant's response to strength training. Nevertheless, 6 weeks of training significantly improved muscle strength and performance irrespective of AHTD or statin use.

Comparison of efficacy between trimetazidine and cilostazol in the treatment of arteriosclerosis obliterans in lower extremity

This study compared the efficacy and long-term survival rate of trimetazidine and cilostazol in the treatment of lower extremity arteriosclerosis obliterans (ASO). A retrospectively analysis on the medical records of 206 patients with ASO who were admitted to The Central Hospital of Wuhan from January 2011 to May 2013 was performed, including 94 patients treated with trimetazidine (group A) and 112 patients treated with cilostazol (group B). On the basis of the same basic treatment, both groups were applied with these two drugs after two courses of treatments. Then the efficacy of clinical treatment, dorsal artery blood flow, anterior femoral artery, posterior tibial artery blood flow, brachial artery index, toe-brachial index, painless walking distance, maximum walking distance, adverse reactions, 5-year survival rates were compared. The total effective rate of clinical efficacy in group B was higher than group A (P<0.05). After the first course of treatment, the above indicators increased in both groups (P<0.05). After the end of the second course of treatment, the above-mentioned index values in both groups were significantly increased (P<0.05). The improvement of the above indicators in group B were better than the trimetazidine group in both the first and second treatment courses (P<0.05). In group A, there were 15 cases of patients with lethargy and hypodynamia and 9 cases of dizziness and headache. There were significant differences between the 7th and 3rd cases of patients when compared to group B (P<0.05). The 5-year survival rate of group A was lower than group B (P<0.05). The clinical efficacy of cliostazol in the treatment of ASO had a good effect, and there was only a few adverse reactions and the long-term survival rate was high. It is worthy of being promoted in clinical practice.