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by Robert MacKay, Wednesday, November 28, 2012 | Categories: Statins

Although the use of statins and the benefits of exercise are commonly discussed with patients with hyperlipidaemia; up until now the topic of combining exercise with statins had not been fully investigated. Now, a large-scale study claims that moderate exercise, such as brisk walking 150 minutes per week, can lower the mortality risk substantially among individuals with hyperlipidaemia.

The prospective cohort study, which was published in The Lancet, included a total of 10,043 participants from Veteran Affairs Medical Centers in the US. The average age of the participants was 58, and within the sample 5046 were statin users, and 4997 were not statin users. During the first assessment, the participants took part in a standard physical test where it was required that they run on a treadmill until they felt exhausted. By inserting the peak exercise time and peak speed into an equation, the researchers were able to estimate so-called MET (metabolic equivalents) values for exercise. Based on these values, participants were split into four groups according to fitness level. They were then further divided each group into statin and non-statin users. The participants were followed up ten years later to analyse whether exercise (in combination with statins or on its own) decreases mortality. The key results indicated that individuals who used statins and were considered the most fit had 70% lower mortality risk than the least fit participants within this group. Among the non-statin users, the least fit individuals had an increased mortality hazard of 35% whereas the fittest individuals had a 47% reduction in hazard ratio. This led researchers to conclude that exercise decreases mortality for all individuals, and that exercise may be a particularly useful tool to use in combination with statins. Perhaps the most important conclusion was that these findings were independent from other clinical characteristics.

In addition to the large sample and the long follow-up period, there are several aspects of the study that are commendable within the analysis. Given that the sample was taken from Veteran Centres, the researcher had access to medical history that enabled them to consider confounding variables. Moreover, during the follow up the participants who had died were excluded in a second analysis in order to ensure that the results were more sensitive. It is worth mentioning that there was no data regarding cardiovascular interventions and cardiovascular mortality, diet or whether statin treatment interfered with exercise. However, these limitations could be adequately addressed in a future clinical trial.

We are not surprised to hear about these findings, as we have been advocates for exercise for a long time. However, we are somewhat astonished at the extent moderate exercise appears to be helpful in reducing mortality in patients who take statins. This robust study clearly demonstrates how important it is to incorporate exercise into everyday life and we hope the findings make a difference among individuals whether they are prescribed statins or not. 





 
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