The challenge of combining Statin Therapy and Physical Activity to reduce cardiovascular risk

A publication Recent work from the MP03-Lupus group of the Biosanitary Research Institute of Granada (ibs.GRANADA) proposes an updated approach for the simultaneous prescription of statin therapy and physical activity, attempting to optimize the cardiovascular benefits of both and minimize possible interactions. In this study, the most common scenarios in clinical practice and the possible barriers that may appear during the combined prescription of both therapies are addressed.

Statins, medications commonly prescribed to lower cholesterol levels, have been associated with adverse muscle symptoms, frequently leading to treatment discontinuation and an increase in cardiovascular events. However, the most recent evidence suggests that many of these adverse muscle effects are not caused directly by statins, but by the nocebo effect, that is, adverse effects induced by the patient's own negative expectations (the belief that muscle pain will appear). ). Furthermore, the relationship between physical exercise and the occurrence of muscle adverse effects in patients taking statins has been unjustifiably exaggerated, creating unfounded fears in patients who could benefit from staying physically active.

This team of Andalusian scientists, belonging to ibs.GRANADA, Virgen de las Nieves University Hospital and the University of Almería, proposes guidelines to guide the joint prescription of statins and physical activity considering the most frequent scenarios in routine clinical practice: initiation of statins in physically inactive patients, initiation of physical activity in patients treated with statins, and initiation of statins in physically active patients or professional athletes.

In relation to physical activity, the ibs.GRANADA authors highlight the importance of reducing sedentary behavior and performing strength training, avoiding, as has traditionally been done, relating physical activity exclusively to aerobic activity. Furthermore, the importance of making a personalized adaptation of the training parameters (type, frequency, intensity, duration) is emphasized to allow a correct adaptation of the body.

The work also addresses the barriers that medical professionals face in making physical activity recommendations in patients at cardiovascular risk, such as lack of time and training in this area. Faced with this last limitation, the article itself provides specific resources and strategies such as those proposed by the initiative “Exercise Is Medicine” from the American College of Sports Medicine.

In summary, the proposal made by ibs.GRANADA, together with other entities such as the Virgen de las Nieves University Hospital, the University of Almería and the John Ochsner Heart and Vascular Institute (United States), presents a comprehensive and updated review on how combine the prescription of statins and physical activity. It is expected that this review will stimulate new research that will contribute to improving the cardiometabolic health of patients at cardiovascular risk.

About the group

The MP03-Lupus group of ibs.GRANADA, led by José Mario Sabio Sánchez, develops its research in patient populations with high cardiovascular risk. His main current lines of research are the study of the benefits of physical exercise in systemic lupus erythematosus and in patients with familial hypercholesterolemia.

More information about the group https://www.ibsgranada.es/grupos-de-investigacion/mp03-lupus/

https://www.sportresearchgroup.es/

Bibliographic reference: Gavilán-Carrera, B., Soriano-Maldonado, A., Mediavilla-García, JD, Lavie, CJ, & Vargas-Hitos, JA (2023). Prescribing statin therapy in physically (in)active individuals vs prescribing physical activity in statin-treated patients: A four-scenario practical approach. Pharmacological Research, 197, 106962. https://doi.org/10.1016/j.phrs.2023.106962

Link to the publication: https://www.sciencedirect.com/science/article/pii/S1043661823003183?via%3Dihub

Image (left to right): José Antonio Vargas Hitos (ibs.Granada and Virgen de las Nieves University Hospital), Blanca Gavilán Carrera (ibs.Granada and Virgen de las Nieves University Hospital) and Alberto Soriano Maldonado (Sport Research Group CTS-1024, University of Almería)