Table 3.

Studies Relating Statin Use and Physical Activity

Reference, YearStudy PopulationDesign, InterventionFindingsSORT Study QualityComments
Panza et al,46 2015418 adults not taking statins
Age 44 ± 16.1 years
50% men
RCT; high-dose statin vs placebo for 6 monthsPA ↓ over time in placebo and statin arms equallyLevel 1*Young; very few at high activity levels
Used accelerometry
Parker et al,40 2013420 healthy adults not taking statins
50% men
RCT; high-dose statin vs placebo for 6 monthsPA ↓ 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 1Young; very few at high activity levels
Used accelerometry
Golomb et al,47 20121016 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 monthsScale-rated energy levels ↓ and fatigue with exertion ↑ with statins
Effects worse for women
Level 14 in 10 women noted some harm
2 in 10 noted harm overall
Mikus et al,48 201337 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 weeksStatin attenuated ↑ in cardiorespiratory fitness (↑ 1.5% with statin vs 10%)Level 2No placebo control
Younger population
Scott et al,49 2009774 noninstitutionalized older adults
Age 62 ± 7 years
52% men
Prospective cohort study, 2.6 yearsStatin users had reduced leg strength over 2.6 years vs controlsLevel 2Strength measured by dynamometry
Qureshi et al,50 201517,264 adults
Age 59 ± 8 years
54% men
Prospective cohort study, 5.4 yearsStatins did not affect peak treadmill performance
Statin users were more sedentary
Level 2Mortality study comparing the benefits of fitness and statins
Lee et al, 5120145994 elderly men
Age ≥65
100% men
Prospective cohort study, 6.9 yearsMen taking statins had a 10% ↓ in PA and showed more sedentary behavior
New statin users had the most rapid decline in PA
Level 2PA measured by accelerometry
Moderate PA ↓ 9.6% and vigorous PA ↓ 9% among statin users
Williams et al,45 201566,377 runners and 12,031 walkers not taking statins
Age 21–82 years
55% men
Prospective cohort study, 7.2 yearsPA levels ↓ in all hypercholesterolemic people, whether taking statins or not
? Reverse causality (↓ PA may have led to high lipids)
Level 2Majority age 40–50 years
Rate of statin discontinuation was not recorded
Low-dose statins
Bruckert et al,18 20057924 unselected hyperlipidemic patients taking high-dose statins
Age 18–75 years
70% men
Observational, cross-sectional studyMuscle symptoms in 10.5%
38% of these were unable to tolerate moderate activity
Level 3Self-report of activity
No placebo control
14% with high PA levels had muscle symptoms
Terpak et al,52 2015749 swimmers, 558 controls
Age ≥35 years
Cross-sectional studyStatin use not associated with change in swimming activityLevel 3Self-report of activity
Cham et al,53 2010354 adults taking statins
Age 34–86 years
53% men
Case seriesOne-third met causality criteria for statin myalgia
Activities most affected were running and walking
Level 3Subjects were self-selected
Sinzinger et al,43 200422 elite athletes with familial hypercholesterolemia
Age 13–35 years
68% men
Case series80% were unable to tolerate any statin doseLevel 3Series 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.