# ACES - ACE inhibitors Combined with Exercise for hypertensive Seniors

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $573,072

## Abstract

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
men and women > 65 years of age with functional limitations and hypertension will be recruited from two sites
to participate in a 36 week intervention study. Participants 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. The primary aim is to determine if, compared to losartan and HCTZ, perindopril improves self-
paced gait speed. The secondary aim is to determine the relative effect of perindopril on a) exercise capacity,
b) body mass and composition, and c) circulating indices of cardiovascular risk. In exploratory analyses,
skeletal muscle biopsies will be collected to evaluate the influence of study drugs on indices of skeletal muscle
angiogenesis. 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:** 9980747
- **Project number:** 5R01AG056769-04
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Thomas W Buford
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $573,072
- **Award type:** 5
- **Project period:** 2017-09-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980747

## Citation

> US National Institutes of Health, RePORTER application 9980747, ACES - ACE inhibitors Combined with Exercise for hypertensive Seniors (5R01AG056769-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9980747. Licensed CC0.

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