Statins and Physical Activity in Older Men

Lee, David S. H.; Markwardt, Sheila; Goeres, Leah M.; Lee, Christine G.; Eckstrom, Elizabeth; Williams, Craig D.; Fu, Rongwei; Orwoll, Eric S.; Cawthon, Peggy M.; Stefanick, Marcia L.; Mackey, Dawn C.; Bauer, Douglas C.; Nielson, Carrie M.

doi:10.1001/jamainternmed.2014.2266

Cited by 82 publications

(24 citation statements)

References 28 publications

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“…Unlike in adult studies (25), we did not observe a worsening of lifestyle factors over time after starting statin therapy. Notably, despite receiving at least six months of lifestyle intervention in a multidisciplinary subspecialty clinic, patients in this study of high-risk children and adolescents had high prevalence of obesity and non-optimal lifestyle factors.…”

Section: Discussioncontrasting

confidence: 99%

Correlates of Achieving Statin Therapy Goals in Children and Adolescents with Dyslipidemia

Mendelson

Regh

Chan

et al. 2016

The Journal of Pediatrics

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Objective To determine the real world effectiveness of statins and impact of baseline factors on low-density lipoprotein cholesterol (LDL-C) reduction among children and adolescents. Study design We analyzed data prospectively collected from a quality improvement initiative in the Boston Children’s Hospital Preventive Cardiology Program. We included patients ≤ 21 years of age initiated on statins between September 2010 and March 2014. The primary outcome was first achieving goal LDL-C, defined as <130 mg/dL, or <100 mg/dL with high-level risk factors (e.g. diabetes, etc.). Cox proportional hazards models assessed the impact of baseline clinical and lifestyle factors. Results Among the 1521 pediatric patients evaluated in 3813 clinical encounters over 3.5 years, 97 patients (6.3%) were started on statin therapy and had follow-up data (median age 14 [IQR 7] years), 54% were female, 24% obese, 62% with at least one lifestyle risk factor. The median baseline LDL-C was 215 (IQR 78) mg/dL and median follow-up after starting statin was 1.0 (IQR 1.3) year. The cumulative probability of achieving LDL-C goal within 1 year was 60% (95% CI 47, 69). Male sex (HR 0.5 [95% CI 0.3, 0.8]) and higher baseline LDL-C (HR 0.92 [95% CI 0.87, 0.98] per 10 mg/dL) were associated with not achieving LDL-C goals, but not age, BMI percentile, lifestyle factors or family history. Conclusions The majority of pediatric patients started on statins reached LDL-C treatment goals within 1 year. Males and those with higher baseline LDL-C were less likely to be successful and may require increased support.

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Section: Discussioncontrasting

confidence: 99%

Correlates of Achieving Statin Therapy Goals in Children and Adolescents with Dyslipidemia

Mendelson

Regh

Chan

et al. 2016

The Journal of Pediatrics

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“…In addition, Bruckert et al (7) indicated that 38% of patients receiving high-dosage statin therapy in a usual care setting reported that their muscular symptoms prevented moderate exertion during everyday activities; again, suggesting that subjects may have compensated for their statin associated muscular symptoms by limiting daily physical activity. Lee and colleagues (17) were the only other researchers to use accelerometers to examine the effect of statins on physical activity and found that statin users decreased their self-reported physical activity over time significantly more than non-statin users. Approximately 12% (7) and 50% (30) of the subject population taking statins in the studies by Sirvent et al (30) and Brucket et al (7) had myalgia symptoms compared to only 7% of symptomatic subjects in our sample (23).…”

Section: Discussionmentioning

confidence: 99%

“…However, statin therapy is associated with an increased risk of myalgia or “muscle pain”, muscle cramps, and muscle weakness that may affect medication adherence and activities of daily living (31). The true incidence of myalgia is not known, however, estimates indicate that myalgia may occur in 1% of patients in pharmaceutical trials (17) to 10–25% of patients in non-industry funded trials (7,24,26). When reported by patients on statin therapy, the symptoms of myalgia seem to appear more frequently during and after physical activity (9,18,19,29).…”

Section: Introductionmentioning

confidence: 99%

“…To the best of our knowledge, Bruckert et al (7) and Lee et al (17) have conducted the only studies examining habitual physical activity levels among individuals receiving statin therapy. Bruckert et al (7) enrolled 7,924 participants with hyperlipidemia and compared non-symptomatic and symptomatic statin user’s physical activity levels.…”

Section: Introductionmentioning

confidence: 99%

“…Lee et al (17) examined longitudinal changes of physical activity levels in statin users vs a placebo control over an average of 6.9 yr in 3,039 men >65 yr using the Physical Activity Scale for the Elderly (PASE; baseline and two months) and accelerometers (4–7 yr after baseline). Of these, 727 (24%) were prevalent statin users, 1,467 (48%) were statin naïve, and 845 (28%) were new statin users.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Atorvastatin on Habitual Physical Activity among Healthy Adults

Panza

Taylor

Thompson

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Statin therapy can result in muscle pain, cramps, and weakness that may limit physical activity although reports are mixed. We conducted a randomized control trial to examine the effect of atorvastatin on habitual physical activity levels among a large sample of healthy adults. Methods Participants (n=418) were statin-naïve adults [44.0±16.1yr (X±SD)] that were randomized and double-blinded to 80mg per day of atorvastatin or placebo for 6 months. Accelerometers were worn for 96hr before and after drug treatment. Repeated measures analysis tested physical activity levels after versus before drug treatment among groups with age and VO2max as covariates. Results Among the total sample, sedentary behavior increased (19.5±5.1min·d−1), while light (9.1±3.0min·d−1) and moderate intensity (9.7±2.8min·d−1) physical activity decreased, as did total activity counts (17.8±6.3·d−1×10−3) over 6 months (P<0.01), with no differences between groups. The atorvastatin group increased sedentary behavior (19.8±7.4min·d−1), and decreased light (10.7±4.3min·d−1) and moderate (8.5±4.0min·d−1) intensity physical activity (P<0.05); while the placebo group increased sedentary behavior (19.2±7.1min·d−1), and decreased moderate intensity (11.0±3.8min·d−1) and total physical activity counts (−23.8±8.8×10−3·d−1) (p<0.05). Conclusion Time being sedentary increased and physical activity levels decreased among the total sample over 6 months of drug treatment, independent of group assignment. Our results suggest that statins do not influence physical activity levels any differently than placebo, and the lack of inclusion of a placebo condition may provide insight into the inconsistencies in the literature.

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