Older men who take cholesterol-busting statins appear to exercise less than counterparts not taking them, raising concerns about a group of the population that is already too inactive - further inactivity could also reduce the benefit of the drug. These were the findings of a new study published in JAMA Internal Medicine and led by Oregon State University in the US.
Nearly one third of older Americans take statins, one of the most widely prescribed medicines in the world. They are normally prescribed for lowering cholesterol and reducing risk of heart attack and stroke.
There has been much controversy surrounding statins recently, as highlighted by the withdrawal by BMJ authors of statements about statins' adverse effects.
Concerns statin use may lead to reduced activity
These latest findings raise concerns because older adults need to exercise to maintain a proper weight and prevent cardiovascular disease, and also to maintain physical strength and function, explains lead author David Lee, assistant professor in the Oregon State University/Oregon Health & Science University College of Pharmacy:
Researchers say the side effects of statins may be to blame for reduced activity among older males who take statins.
"We're trying to find ways to get older adults to exercise more, not less," he adds. "It's a fairly serious concern if use of statins is doing something that makes people less likely to exercise."
Although the study did not investigate why men on statins seem to be less physically active, the authors question whether some of the drug's side effects may be to blame. These include muscle pain and disruption of the function of mitochondria - the tiny powerhouses inside cells - which can cause fatigue and muscle weakness.
Prof. Lee says up to 30% of people who take statins experience muscle pain, and some also report lacking energy and feeling weak and tired.
While previous studies have already found statin use among older adults is linked to lower levels of physical activity, they have tended to be short-term.
Men who took statins averaged about 40 minutes less moderate exercise in a week
Prof. Lee and colleagues analyzed data on men aged 65 and over, living in various parts of the US, who enrolled in the Osteoporotic Fractures in Men Study between 2000 and 2002. They were followed for up to 7 years later.
The team compared changes in physical activity among users and non-users of statins. In some parts of the study, the participants wore accelerometers for a week, giving a minute-by-minute record of their level of activity.
When they analyzed those results for 3,000 participants, the researchers found men who took statins averaged about 40 minutes less moderate physical activity over a week than counterparts who did not take them.
That is the equivalent of doing 150 minutes less slow-paced walking per week, Prof. Lee points out, adding:
"For an older population that's already pretty sedentary, that's a significant amount less exercise. Even moderate amounts of exercise can make a big difference."
They also found the biggest drop in physical activity was among new statin users.
Prof. Lee says we need to be aware of a possible reduction in physical activity in people who take statins, for it could decrease the benefit of the medication: "If someone is already weak, frail, or sedentary," he says, "they may want to consider this issue, and consult with their doctor to determine if statin use is still appropriate."
As the participants were all older men, the researchers note that they cannot generalize their findings to older women.
The National Institutes of Health and the Medical Research Foundation of Oregon funded the study.