Do angiotensin-converting enzyme (ACE) inhibitors enhance the effect of exercise rehabilitation in patients with hypertension and ACE DD and DI genotypes?

Arch Phys Med Rehabil. 2007 Feb;88(2):262-4. doi: 10.1016/j.apmr.2006.10.018.

Abstract

Objective: To test whether pharmacologic angiotensin-converting enzyme (ACE) inhibition in carriers of the ACE DD or DI (D, deletion; I, insertion of 287 base pairs) genotypes can simulate the genetic advantage of the II genotype and thereby enhance the conditioning effects of aerobic exercise.

Design: Nonrandomized controlled trial.

Setting: Pulmonary institute.

Participants: Twelve sedentary men with controlled hypertension (5 with DD genotype, 7 with DI genotype; age, 53+/-7y) treated by ACE inhibitors (study group) and 10 patients (8 men, 2 women; 2 with DD genotype, 8 with DI genotype; age, 54+/-10y) who were treated by other antihypertensive drugs (controls).

Intervention: Exercise training.

Main outcome measures: Training effect was measured by maximal oxygen uptake (Vo(2)max) anaerobic threshold (Vo(2AT)), and the corresponding work rates (WR) (in watts)-WRmax and WR(AT)-before and after 10 weeks of training.

Results: Vo(2)max increased by a mean of 10% (200mL/min) and WRmax by 14% (25W) in each group (P<.001). Vo(2AT) and WR(AT) tended to increase more in the study group (Vo(2AT): 10% [186+/-35mL/min] vs 5% [100+/-1mL/min]; P<.006; WR(AT): 19% [19+/-2W] vs 12% [11+/-3W]; P<.03; respectively).

Conclusions: This study did not show an enhancement of exercise-related conditioning by pharmacologic ACE inhibition among hypertensive patients with ACE DD and DI genotypes, comparable to the advantage conferred by the II genotype.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anaerobic Threshold / physiology
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Exercise Tolerance / physiology
  • Exercise*
  • Female
  • Gene Deletion
  • Genotype
  • Humans
  • Hypertension / genetics*
  • Hypertension / physiopathology
  • Hypertension / rehabilitation*
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Peptidyl-Dipeptidase A / genetics*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Peptidyl-Dipeptidase A