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J. Clin. Med. 2019, 8(2), 196; https://doi.org/10.3390/jcm8020196

Multimodal Intervention to Improve Functional Status in Hypertensive Older Adults: A Pilot Randomized Controlled Trial

1
Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL 35205, USA
2
Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA
3
Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
4
Department of Aging and Geriatric Research, College of Medicine, Division of Clinical Research, University of Florida, Gainesville, FL 32610, USA
5
Department of Medicine, College of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, FL 32610, USA
6
North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA
*
Author to whom correspondence should be addressed.
Received: 26 December 2018 / Revised: 30 January 2019 / Accepted: 31 January 2019 / Published: 6 February 2019
(This article belongs to the Special Issue Sarcopenia in Older Adults)
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Abstract

This pilot randomized controlled trial (RCT) was designed to provide the preliminary data necessary to conduct a full-scale trial to compare the efficacy of differing first-line antihypertensive medications in improving functional status in older adults, when combined with exercise. The primary objectives were to assess study feasibility, safety, and protocol integrity. Dependent outcomes included gait speed, exercise capacity, body composition, and systemic cardiometabolic biomarkers. Thirty-one physically inactive older adults (70.6 ± 6.1 years) with hypertension and functional limitations were randomly assigned to (1) Perindopril (8 mg/day n = 10), (2) Losartan (100 mg/day; n = 13), or (3) Hydrochlorothiazide (HCTZ: 25 mg/day; n = 8). Participants were also assigned to a 24-week multimodal exercise intervention, separated into an aerobic and concurrent (aerobic + resistance) phase to evaluate potential mode effects. Retention was 84% (26/31), and compliance was >90% and >79% with medication and exercise, respectively. A total of 29 adverse events (Perindopril = 5; Losartan = 12; HCTZ = 11) and one unrelated serious adverse event were observed throughout the trial. Overall, this pilot RCT provided critical data and identified several challenges to ultimately designing and implementing a fully powered trial. View Full-Text
Keywords: angiotensin-converting enzyme inhibitors; antihypertensive medication; exercise; functional status; hypertension; aging angiotensin-converting enzyme inhibitors; antihypertensive medication; exercise; functional status; hypertension; aging
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Baptista, L.C.; Jaeger, B.C.; Anton, S.D.; Bavry, A.A.; Handberg, E.M.; Gardner, A.K.; Harper, S.A.; Roberts, L.M.; Sandesara, B.; Carter, C.S.; Buford, T.W. Multimodal Intervention to Improve Functional Status in Hypertensive Older Adults: A Pilot Randomized Controlled Trial. J. Clin. Med. 2019, 8, 196.

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