# ACES - ACE inhibitors Combined with Exercise for hypertensive Seniors

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2022 · $515,517

## Abstract

The purpose of this project is to conduct a randomized, controlled trial (RCT) to determine if choice of
antihypertensive medication influences changes in functional status and other cardiovascular risk factors
among older persons with hypertension. Functional status, determined by measures of physical performance,
is an important predictor of cardiovascular outcomes in older adults. Seniors with compromised function
experience more CV events, have a higher risk of undergoing cardiac surgery and higher risk of CVD-related
death than higher-functioning peers. Seniors with hypertension experience accelerated declines in function,
and presently physical exercise is the primary strategy for preventing this decline. However, functional
responses to exercise are highly variable and appear to be influenced by the type of antihypertensive
medication(s) utilized to control blood pressure. Preliminary evidence suggests that, compared to other first-
line antihypertensive agents, angiotensin converting enzyme (ACE) inhibitors enhance exercise-derived
improvements in functional status among hypertensive seniors. This RCT will test this hypothesis. Sedentary
older adults with functional limitations and hypertension will be recruited from two sites to participate in a
randomized clinical trial in which they will be randomly assigned to one of three first-line antihypertensive
agents: (1) the ACE inhibitor perindopril, (2) AT1 receptor antagonist losartan, or (3) the thiazide diuretic
hydrochlorothiazide. All participants will also participate in a structured aerobic exercise intervention. This trial
will evaluate whether, compared to losartan and HCTZ, perindopril improves indices of functional status and
cardiovascular risk when combined with physical exercise. This study is expected to differentiate beneficial
effects of three FDA-approved antihypertensive medications on an emerging cardiovascular risk factor in a
clinically-relevant population. Thus the study has important implications for expeditiously influencing clinical
practice guidelines in the prescription of antihypertensive drugs to millions of Americans.

## Key facts

- **NIH application ID:** 10670590
- **Project number:** 3R01AG056769-05S1
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Thomas W Buford
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $515,517
- **Award type:** 3
- **Project period:** 2017-09-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10670590

## Citation

> US National Institutes of Health, RePORTER application 10670590, ACES - ACE inhibitors Combined with Exercise for hypertensive Seniors (3R01AG056769-05S1). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10670590. Licensed CC0.

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