Statins, or HMG-CoA reductase inhibitors, constitute an extremely common class of prescription drugs used in the treatment of hypercholesterolemia, or high serum cholesterol, which is associated with an increased risk of cardiovascular disease. In 2009, one of these medications, Lipitor, was one of the most commonly prescribed drug in the U.S. Given that many people with high cholesterol are advised to take up exercise as part of a comprehensive heart-healthy lifestyle, the potential effects of statins on exercise tolerance are important to evaluate.
What Are Statins and Why Are They Prescribed?
Statins are drugs that block the body's production of cholesterol, a fat-carrying molecule, at a critical synthetic step. Some of the more common proprietary statins are Lipitor, Zocor, Pravachol and Crestor. High blood cholesterol is defined as having a total level above 240 mg/dL or a level of LDL or "bad" cholesterol above 130 mg/dL. Whether or not your medical provider elects to prescribe a statin depends on other risk factors for heart disease, including a positive family history, sedentary lifestyle, advanced age, high blood pressure, smoking, and overweight or obesity. If you are prescribed a statin, be prepared to be on it for the rest of your life.
Minor Side Effects and Exercise
Virtually all drugs have some side effects, and statins are no exceptions. Most people experience only minor side effects, and some of these dissipate as your body adjusts to the drug. These include muscle and joint aches as well as gastrointestinal effects such as nausea, and diarrhea or constipation; all of these may interfere with even light exercise, since muscles and joints may already be sore from working out and gastrointestinal discomfort can grind any exercise routine to a halt. Tell your health care provider if you experience any of these.
More Serious Side Effects and Exercise
Occasionally, people taking statins will experience a significant rise in the blood level of certain liver enzymes, heralding possible damage to the liver. You are unlikely to have symptoms at first when this occurs, so your doctor will schedule a blood test about six weeks after you begin taking a statin. More serious and more pertinent to exercise is a condition known as rhabdomyolysis, or a breakdown of muscle tissue that can lead to kidney damage. This is why it is important to distinguish between normal soreness and "statin soreness," as the latter can lead to serious complications.
Statins, Decreased Cardiac Function and Exercise
Many people prescribed a statin have already been diagnosed with cardiovascular disease, including congestive heart failure or CHF. CHF may be divided into systolic heart failure, SHF, or a decrease in contractile power, or diastolic heart failure, DHF, which is related to poor filling of the heart owing to excessive "stiffness." A 2009 study in "CHEST" demonstrated that while statins often improve exercise capacity in patients with SHF, it may actually worsen exercise tolerance in patients with DHF, suggesting that these medications may be contraindicated in this patient population. Again, a frank discussion with your doctor or other provider is vital to your ongoing treatment for heart disease or the elevated cholesterol levels that may increase your risk of heart trouble.
References
- Pharmacy Times: Top 200 Products in the U.S. Market by Dispensed Prescriptions, 2009
- MayoClinic.com: Statins: Are These Cholesterol-lowering Drugs Right for You?
- "Chest"; Opposite Effect of Statins on Pulmonary Function and Exercise Tolerance in Diastolic Versus Systolic Heart Failure"; Lawrence Cahalin, Ph.D.; Nov. 2009
