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Executive Brief, Summer 2013

Do Statins Block the Benefits of Exercise?

Know the risks and benefits

By Roxanne B Sukol MD MS

Here at Cleveland Clinic, patients are asking us more and more questions about statins, and specifically about one study showing that statins may interfere with the benefits of exercise.

Statins, a type of cholesterol-lowering medication, are the most highly prescribed group of medications in the world. The dilemma surrounds the issue of “primary prevention,” or intervention to prevent a disease from developing. For example, how do you measure the cost savings of a heart attack that never happens?

Study shows statins’ impact

A study conducted by the University of Missouri, and published in the May 2013 Journal of the American College of Cardiology, studied the effect of statins on fitness and muscles. All participants were at increased risk of developing coronary artery disease because they were overweight and also had at least one other risk factor:

  • High blood pressure
  • Elevated cholesterol levels
  • Low overall physical fitness

Participants walked or jogged on a treadmill five times a week for 45 minutes at a moderate pace. Half were randomly selected to take 40 milligrams of simvastatin daily for the 12-week study. After three months of exercise, the unmedicated volunteers improved their aerobic fitness (ability to perform strenuous aerobic exercise) by more than 10 percent on average. In contrast, participants taking the statin improved by barely 1 percent, and some even lost aerobic capacity.

A close-up look

Biopsies of participants’ muscle tissue revealed big differences inside the mitochondria, the tiny parts of cells that regulate energy production. Mitochondria – and the enzymes inside them that support energy production – generally increase in number and potency when someone exercises. In this study, however, enzyme levels rose 13 percent in the non-statin group but fell 4.5 percent in the statin group despite the increase in exercise.

Muscle pain and injury, and occasional serious complications, are acknowledged adverse side effects of statins in some people. A study of marathon runners showed more muscle damage in athletes taking statins -

Are statins for you?

Ideally, doctors would prescribe statins for everyone who might benefit, unless doing so would block the benefits of other interventions — in this case, increased physical activity. The question is, what to do for overweight, inactive individuals whose stress tests are normal, and who have not shown any sign of trouble?

At this point, if you are already taking statins and tolerating your medication, don’t stop. However, if you are on a statin and you develop muscle cramps or pain that you believe may be associated with the statin, call your doctor’s office promptly to schedule an appointment.

Dr. John Thyfault, a professor of nutrition and exercise physiology at the University of Missouri, said “there’s no doubt that statins save lives” for certain groups of people:

  • Those with high cholesterol
  • Those with a family history of high cholesterol, heart disease or diabetes

But for the rest of us, a careful analysis of the risks and benefits is in order.

Investing in your Health by Choosing the Right Personal Trainer

Use these tips to protect your time and money

By Christopher Travers, MS

You have decided to commit to a more serious fitness routine, which includes hiring a personal trainer. Make sure you achieve the most from your newfound dedication and the investment of your time and finances.

Being thorough can mean the difference between finding someone to help you reach your goals and finding someone who is a waste of money. There are five areas to review:

1. Certification and education

Find out if the personal trainer:

  • Has a four-year degree in a health and fitness field
  • Is certified by the National Strength and Conditioning Association (NSCA) or American College of Sports Medicine (ACSM), both of which require a four-year degree
2. Experience

Ask the person you are considering:

  • How long he or she has been a personal trainer
  • The types of clients he or she has worked with in the past
  • For references
3. Safety and evaluation

Find out whether the personal trainer:

  • Offers pre-exercise screening offered to check any physical limitations
  • Is certified in cardiopulmonary resuscitation (CPR)
  • Will regularly assess your progress
4. Accessibility

You can see personal trainers in different settings. Choose the option that will work best for your lifestyle:

  • A personal studio
  • Your home
  • A gym or fitness center
5. Fees, Scheduling and Cancellations

The cost to hire a personal trainer can range from $35 to $100 per hour. Be sure to review the following in their entirety before hiring someone or signing any contract:

  • Session price: Find out what is covered.
  • Session length: Ask what a session involves; don’t pay someone to watch you walk or run on the treadmill.
  • Cancellation Policy: Read the fine print.

Hiring a trainer can help you reach your goals and give you the motivation to go to the gym. But make sure you do your homework. Like most things, you get what you pay for, and your health and well-being are priceless.

Chris Travers is an exercise physiologist who works with our Executive Health Program patients.