Statins are cholesterol-lowering drugs that have likely prevented countless heart attacks. They are the most prescribed drugs in the world. Recently, I blogged about how these drugs might lower the risk of dying from prostate cancer. However, no drug is without downsides, and today we turn to the fact that statins might reduce the benefits of exercise, according to the results of a study published in the Journal of the American College of Cardiology.
Statins and Cholesterol: Cholesterol is a waxy, fat-like substance found in the body and in many foods. It is essential to the ability of our bodies to function. Excess (high) blood cholesterol from inherited genetics, diet, or lifestyle can lead to an increased risk of heart disease. Statins are drugs designed to lower blood cholesterol levels; more specifically, to lower low-density lipoprotein (LDL, or “bad” cholesterol) and triglyceride levels and to raise high-density lipoprotein (HDL, or “good” cholesterol) levels.
But What About Exercise? Statin can help to lower cholesterol. But we have another potential means: Exercise can lower cholesterol and your risk for heart attack. So which is more important? Statins or exercise? The answer is not clear. To better understand the relationship between statins and exercise, researchers conducted a small study involving overweight, sedentary adults at risk of developing high cholesterol or high blood pressure. Participants had slightly elevated cholesterol levels, and none had exercised regularly in the prior year.
- At the start of the study, subjects underwent muscle biopsies and treadmill testing to determine their aerobic fitness levels.
- All participants began a supervised 12-week exercise program (walking or jogging on a treadmill at a moderately vigorous pace for 45 minutes, 5 days per week). Half began taking statins.
Results: After 12 weeks, the exercise-only group’s aerobic fitness had increased 10 percent, compared with only 1.5 percent in the statin group. In addition, the exercise-only group had a 13 percent increase in muscle function, whereas the statin group experienced a 4.5 percent decline in muscle function.
What Should You Do? Both statins and exercise lower the risk of heart attack among those at high risk, including those with high cholesterol. But if statins block benefits of exercise, should you take the drug and skip the exercise? Or skip the statins and do exercise? Well, it’s complicated. Statins appear to hinder mitochondria, the energy-producing parts of cells (that typically increase as a result of exercise, leading to improved fitness). However, while the statins reduced mitochondria in the study presented, they did not negate all benefits of exercise. The participants were burning calories, an important component of staying health and reducing the risk of heart disease, cancer, and other illnesses. We know statins can save lives. We know exercise can save lives. The key may be to individualize how much of each. For example, if your cholesterol is borderline or not very high, it may be recommended that you skip the statins in favor of exercise. And if you are going to go on a statin, you may wish to improve your fitness before you start the drugs. Please check in with a valued health professional before making any decisions, though. I’m Dr. Michael Hunter.
The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.
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Reference: Mikus CR, et al. Simvastatin impairs exercise training adaptations. Journal of the American College of Cardiology. 2013;62(8):709-14. dii: 10.1016/j.jacc.2013.02.074; awomanshealth.com (Winter 2014).