Studies Relating Statin Use and Physical Activity
| Reference, Year | Study Population | Design, Intervention | Findings | SORT Study Quality | Comments |
|---|---|---|---|---|---|
| Panza et al,46 2015 | 418 adults not taking statins Age 44 ± 16.1 years 50% men | RCT; high-dose statin vs placebo for 6 months | PA ↓ over time in placebo and statin arms equally | Level 1* | Young; very few at high activity levels Used accelerometry |
| Parker et al,40 2013 | 420 healthy adults not taking statins 50% men | RCT; high-dose statin vs placebo for 6 months | PA ↓ over time in both placebo and statin arms; ↑ myalgia and CK in statin arm Statin arm had significant myalgia ↑, PA ↓ in >55-year-old age group vs controls | Level 1 | Young; very few at high activity levels Used accelerometry |
| Golomb et al,47 2012 | 1016 adults No CVD or diabetes LDL 3.0 to 5.0 mmol/L Age ≥20 years 67% men | RCT; moderate-dose statin vs placebo for 6 months | Scale-rated energy levels ↓ and fatigue with exertion ↑ with statins Effects worse for women | Level 1 | 4 in 10 women noted some harm 2 in 10 noted harm overall |
| Mikus et al,48 2013 | 37 sedentary overweight or obese adults with ≥2 MS risk factors not taking statins Age 25–59 years 35% men | RCT; moderate-dose statin + PA vs PA alone for 12 weeks | Statin attenuated ↑ in cardiorespiratory fitness (↑ 1.5% with statin vs 10%) | Level 2 | No placebo control Younger population |
| Scott et al,49 2009 | 774 noninstitutionalized older adults Age 62 ± 7 years 52% men | Prospective cohort study, 2.6 years | Statin users had reduced leg strength over 2.6 years vs controls | Level 2 | Strength measured by dynamometry |
| Qureshi et al,50 2015 | 17,264 adults Age 59 ± 8 years 54% men | Prospective cohort study, 5.4 years | Statins did not affect peak treadmill performance Statin users were more sedentary | Level 2 | Mortality study comparing the benefits of fitness and statins |
| Lee et al, 512014 | 5994 elderly men Age ≥65 100% men | Prospective cohort study, 6.9 years | Men taking statins had a 10% ↓ in PA and showed more sedentary behavior New statin users had the most rapid decline in PA | Level 2 | PA measured by accelerometry Moderate PA ↓ 9.6% and vigorous PA ↓ 9% among statin users |
| Williams et al,45 2015 | 66,377 runners and 12,031 walkers not taking statins Age 21–82 years 55% men | Prospective cohort study, 7.2 years | PA levels ↓ in all hypercholesterolemic people, whether taking statins or not ? Reverse causality (↓ PA may have led to high lipids) | Level 2 | Majority age 40–50 years Rate of statin discontinuation was not recorded Low-dose statins |
| Bruckert et al,18 2005 | 7924 unselected hyperlipidemic patients taking high-dose statins Age 18–75 years 70% men | Observational, cross-sectional study | Muscle symptoms in 10.5% 38% of these were unable to tolerate moderate activity | Level 3 | Self-report of activity No placebo control 14% with high PA levels had muscle symptoms |
| Terpak et al,52 2015 | 749 swimmers, 558 controls Age ≥35 years | Cross-sectional study | Statin use not associated with change in swimming activity | Level 3 | Self-report of activity |
| Cham et al,53 2010 | 354 adults taking statins Age 34–86 years 53% men | Case series | One-third met causality criteria for statin myalgia† Activities most affected were running and walking | Level 3 | Subjects were self-selected Self-report |
| Sinzinger et al,43 2004 | 22 elite athletes with familial hypercholesterolemia Age 13–35 years 68% men | Case series | 80% were unable to tolerate any statin dose | Level 3 | Series of professional athletes monitored in clinic for 8 years Young population |
CK, creatine kinase; CVD, cardiovascular disease; LDL, low-density lipoprotein; MS, metabolic syndrome; PA, physical activity; RCT, randomized controlled trial.
↵* SORT represents the Strength of Recommendation Taxonomy rating of study quality determined by Ebell et al.22
↵† Muscle symptoms improved upon reducing or discontinuing the statin dose and resumed upon restarting the drug.