Statins and Exercise, Independently Beneficial, Even Better In Combination
Statins are commonly prescribed for management of dyslipidaemia and cardiovascular disease. Increased fitness is also associated with low mortality and is recommended as an essential part of promoting health. However, little information exists about the combined effects of fitness and statin treatment on all-cause mortality.
Now a new study offers fresh evidence that the two appear to be independently beneficial, and that adding the two together may result in greater benefits than either alone.
In the prospective cohort study, Peter F Kokkinos and colleagues assessed 10 043 veterans with dyslipidemia (mean age 58.8 years) from VA medical centers in Palo Alto, CA and Washington DC who had an exercise tolerance test between 1986 and 2011.
Individuals were assigned to one of four fitness categories based on METs achieved during exercise testing and eight categories based on fitness status and statin treatment. The primary end point was all-cause mortality adjusted for age, body-mass index, ethnic origin, sex, history of cardiovascular disease, cardiovascular drugs, and cardiovascular risk factors. They ascertained mortality from VA records on December 31, 2011.
During a median follow-up of 10 years, 2318 participants died. Mortality risk was 18.5% in people taking statins versus 27.7% in those not taking statins.
Statins With Better Physical Fitness Can Boost Survival
In patients who took statins, risk of death decreased as fitness increased.
Highly Fit Not on Statins Had Lower Mortality Than Unfit on Statins
Strikingly, the study found that patients not prescribed statins but who were highly fit still had a significantly lower risk of mortality than those taking statins who were unfit.
This study reinforces the importance of physical activity for individuals with dyslipidaemia.
Kokkinos PF, Faselis C, Myers J, et al. Interactive effects of fitness and statin treatment on mortality risk in veterans with dyslipidemia: a cohort study. Lancet 2012; DOI: 10.1016/S0140-6736(12)61426-3.
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