ACE-INHIBITION AND PHYSICAL EXERCISE - STUDIES ON PHYSICAL WORK CAPACITY, ENERGY-METABOLISM, AND MAXIMUM OXYGEN-UPTAKE IN WELL-TRAINED, HEALTHY-SUBJECTS

We investigated the effects of the angiotensin-converting enzyme (ACE) inhibitor trandolapril (2 mg/o.d.) on the physical work capacity (PWC ), the received perception of exertion (RPE), as well as parameters de termining physical performance (i.e., energy metabolism, lactate produ ction, and oxygen uptake) in well-trained, healthy subjects. Twenty ma le sports students underwent a bicycle spiroergometry until exhaustion to determine maximum work load, maximum oxygen uptake, lactate thresh old, and parameters of energy metabolism. The identical protocol was r epeated after a 14-day treatment period with 2 mg of trandolapril o.d. or placebo. Treatment with the ACE inhibitor did not significantly al ter maximum PWC, RPE, 4.0 mmol/L lactate threshold, heart rate, maximu m oxygen uptake, plasma levels of total cholesterol, triglycerides, fr ee fatty acids, glucose, insulin, cortisol, and human growth hormone. In the presence of the ACE inhibitor, the exercise-induced increase in systolic blood pressure was moderately (n.s.) blunted (204 +/- 7 vers us 192 +/- 7 mm Hg). Treatment with the ACE inhibitor did not impair p hysical performance and RPE. This favorable profile of action was acco mpanied by no alterations in maximum oxygen uptake and parameters of e nergy metabolism at all levels of exercise intensity. Therefore, it ma y be concluded that antihypertensive treatment with an ACE inhibitor s hould be primarily considered in physically active patients.