{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:50:09Z","timestamp":1790650209189,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2023,7,18]]},"abstract":"<jats:p>Background: Hypertension and skeletal muscle decline are common findings in patients with Alzheimer\u2019s disease (AD). Angiotensin-converting enzyme (ACE) inhibitors preserve skeletal muscle and physical capacity; however, the driving mechanisms are poorly understood. Objective: We investigated the effects of ACE inhibitors on the neuromuscular junction (NMJ) with relevance to skeletal muscle and physical capacity in AD patients and age-matched controls. Methods: We evaluated controls (n\u200a=\u200a59) and three groups of AD patients, including normotensive (n\u200a=\u200a51) and patients with hypertension taking ACE inhibitors (n\u200a=\u200a53) or other anti-hypertensive medications (n\u200a=\u200a49) at baseline and one year later. We measure plasma c-terminal agrin fragment-22 (CAF22) as a marker of NMJ degradation, handgrip strength (HGS), and Short Physical Performance Battery (SPPB) as markers of physical capacity. Results: At baseline AD patients demonstrated lower HGS and SPPB scores and higher CAF22 levels than controls, irrespective of the hypertension status (all p\u200a&lt;\u200a0.05). The use of ACE inhibitors was associated with higher HGS and relative maintenance of SPPB scores, gait speed, and plasma CAF22 levels. Conversely, other anti-hypertensive medications were associated with an unaltered HGS, reduced SPPB scores and elevated plasma CAF22 levels (both p\u200a&lt;\u200a0.05). We also found dynamic associations of CAF22 with HGS, gait speed, and SPPB in AD patients taking ACE inhibitors (all p\u200a&lt;\u200a0.05). These changes were associated with reduced oxidative stress in AD patients taking ACE inhibitors (p\u200a&lt;\u200a0.05). Conclusion: Altogether, ACE inhibitors are associated with higher HGS, preserved physical capacity, and the prevention of NMJ degradation in hypertensive AD patients.<\/jats:p>","DOI":"10.3233\/jad-230201","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T10:24:08Z","timestamp":1686651848000},"page":"641-650","source":"Crossref","is-referenced-by-count":25,"title":["ACE Inhibitors Improve Skeletal Muscle by Preserving Neuromuscular Junctions in Patients with Alzheimer\u2019s Disease"],"prefix":"10.1177","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-7172","authenticated-orcid":false,"given":"Rizwan","family":"Qaisar","sequence":"first","affiliation":[{"name":"Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates"},{"name":"Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asima","family":"Karim","sequence":"additional","affiliation":[{"name":"Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Shahid","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaea A.","family":"Alkahtani","sequence":"additional","affiliation":[{"name":"Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdos","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates"},{"name":"Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates"},{"name":"Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossam","family":"Kamli","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-230201_ref1","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/YCO.0000000000000684","article-title":"Hypertension and Alzheimer\u2019s disease: Is the picture any clearer?","volume":"34","author":"Lennon","year":"2021","journal-title":"Curr Opin Psychiatry"},{"key":"10.3233\/JAD-230201_ref2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.neures.2022.08.004","article-title":"Elevated plasma zonulin and CAF22 are correlated with sparcoenia and functional dependency at various stages of Alzheimer\u2019s diseases","volume":"184","author":"Karim","year":"2022","journal-title":"Neurosci 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