Statins Plus Exercise: New Study Questions the Combination

Will the results of a small, non-blinded study on the impact of statin medication on exercise have broad implications for the future of a class of drugs primary care physicians prescribe every day? It is far too early, say the study authors, to make any judgments about the outcome of the research. But the data reported in “Simvastatin impairs exercise training adaptations” do re-focus attention on prior concern about the effects of statins on skeletal muscle. The study appeared in June in the Journal of the American College of Cardiology.

Statins Plus Exercise

In this podcast, CardiologyNow host Dr Payal Kohli discusses the study and its results with study co-author Dr Catherine Mikus. Dr Kohli (top) is a cardiology fellow at the University of California San Francisco. Dr Mikus (bottom) is a postdoctoral scholar in the Division of Cardiology at Duke University Medical Center.

Take-home Points:
1. Statins and exercise are commonly prescribed in conjunction with one another. However, this small, 12-week, randomized study showed that simvastatin 40 mg once daily can attenuate increases in skeletal muscle mitochondrial content and cardiorespiratory fitness in response to exercise training.

2. Additional studies are needed to determine whether: (1) this is a class effect applicable to all statins; (2) there is a time-dependent interaction between statins and fitness such that statins simply delay fitness in response to exercise; (3) exercise affects statin-induced myopathy.

3. Exercise has an abundance of health benefits, including many that are unrelated to improvements in fitness. Physicians should encourage their patients to be physically active, regardless of whether or not they are using statins.

Reference
Mikus CR, Boyle LJ, Borengasser SJ, et al. Simvastatin impairs exercise training adaptation. J Am Coll Cardiol. 2013.  doi:10.1016/j.jacc.2013.02.074. [Epub ahead of print]