Moderate exercise does not worsen statin-related muscle soreness, study finds

New data suggest the existence of Statin-related muscle symptoms It was not associated with worse exercise-induced muscle damage in statin users.¹

Among the most commonly reported adverse events associated with statin use, the results of a study involving both symptomatic and asymptomatic statin users with perceived or actual muscle soreness were associated with risk We provide evidence detailing the association between exercise and positive health benefits in these patients without increasing muscle damage.¹

Neeltje Allard, MD, Principal Investigator, Department of Integrative Physiology, Radboud University School of Medicine, said: center.² “These results suggest that moderate-intensity exercise for extended periods of time is safe for statin users and can help statin users maintain a physically active lifestyle and derive cardiovascular health benefits.” It shows that it can be done.”

Due to the lack of definitive literature on the safety of moderate exercise in patients with statin-related muscle symptoms, Allard and colleagues’ team proposed moderate to muscle injury in symptomatic versus asymptomatic statins. The study was designed to compare the effects of high-intensity exercise. users, and non-statin-using controls.¹

Exclusion criteria for this study included diabetes, hypothyroidism or hyperthyroidism, known hereditary skeletal muscle deficiencies, other diseases known to cause muscle symptoms, or coenzyme Q10 (CoQ10) supplementation Overall, the researchers included 35 symptomatic statin users, 34 asymptomatic statin users, and 31 control subjects in the study. has been identified. For analysis purposes, participants were randomized to walk 30, 40, or 50 km per day on her four consecutive days.¹

For analytical purposes, muscle injury was measured using lactate dehydrogenase, creatine kinase, myoglobin, cardiac troponin I, and N-terminal pro-brain natriuretic peptide. In secondary analyses, the investigators planned to estimate associations between leukocyte CoQ10 levels and muscle markers, muscle performance, and reported muscle symptoms.¹

The results of the researchers’ initial analysis showed that all muscle damage markers were comparable at baseline (P. > .05) and a post-exercise increase (P. <.001), and there is no difference in the magnitude of exercise-induced elections between groups (P. >.05). Further analysis suggested that myalgia scores were greatest in the symptomatic statin user group at baseline (P. <.001). During the study, muscle pain scores increased similarly in all groups after exercise (P. <.001).¹

Additional analysis revealed that muscle relaxation times were increased in symptomatic statin users more than in control subjects after exercise (P.=.035). When assessing CoQ10 levels, the results were as follows: symptomatic (2.3 nmol/U; IQR: 1.8-2.9 nmol/U), asymptomatic statin users (2.1 nmol/U; and showed no difference in levels between controls. Subject (2.1 nmol/U; IQR: 1.8-2.3 nmol/U]; P.=.20) and was not associated with muscle injury markers, fatigue resistance, or reported muscle symptoms.¹

Published in parallel with this study was an editorial by Robert Rosenson, MD, of the Metabolic and Lipid Unit of Zena and the Michael A. Wiener Cardiovascular Institute, Mount Sinai Heart. In an editorial, Rosenson praises the authors’ efforts and research results. Later in the editorial, Rosenson presents his views on the results and how they affect the management of patients on statin therapy.³

“In summary, many patients who develop SAMS may engage in moderately intensive walking programs without worrying about muscle biomarkers or performance deterioration.³ “In this short-term study, exercise increased fatigue in symptomatic and asymptomatic statin users, whereas sustained exercise in patients with SAMS improved metabolic biomarkers or exercise performance in the long-term.” It remains unclear from this study whether it results in

References

1. Allard N, Janssen L, Lagerwaard B, et al. Long-term moderate-intensity exercise does not increase markers of muscle damage in symptomatic or asymptomatic statin users. Jay Am Col Cardiol. April 2023, 81 (14) 1353–1364.https://doi.org/10.1016/j.jacc.2023.01.043
2. Moderate Exercise Safe for People With Statin-Induced Muscle Pain – American College of Cardiology. American College of Cardiology. Published April 3, 2023.pain from statins
3. Rosenson R, et al. Importance of exercise in cardiometabolic health in patients reporting statin-related muscle symptoms*. Jay Am Col Cardiol. April 2023, 81 (14) 1365–1367. https://doi.org/10.1016/j.jacc.2023.02.011