Statins plus improved exercise substantially lowered mortality risk

Combining statin treatment with moderate exercise significantly lowered mortality risk for patients with dyslipidemia better than treatment or exercise alone, according to study results published in The Lancet.

Researchers assessed 10,043 dyslipidemic veterans (mean age, 58.8 years) during a 10-year period. All participants had an exercise tolerance test from 1986 to 2011. Using a measure of the peak metabolic rate (MET) achieved during the exercise test, the researchers classified fitness level as least, moderate, fit or high. Patients were then divided into two groups — statin treatment or no statin treatment — within each fitness category.

Mortality risk was 18.5% for participants who used statins vs. 27.7% for those who did not use statins (P<.0001). Among statin users, mortality risk decreased as fitness increased; highly-fit participants (>9 METs; n=694) had a HR of 0.3 (95% CI, 0.21-0.41) whereas the least-fit participants (≤5 METs; n=1,060) had a HR of 1. Among participants who did not use statins, the HR for least-fit participants (n=1,024) was 1.35 (95% CI, 1.17-1.54). The researchers also noted a progressive decrease in mortality risk for highly-fit participants who did not use statins (n=1,498; HR=0.53; 95% CI, 0.44-0.65).

Peter F. Kokkinos

“The most surprising finding was the impact of small improvements in fitness on mortality reduction. The risk for the moderate-fit group (7 to 9 METs) not taking statins was about 20% lower when compared with the least-fit participants taking statins. So, relatively small gains in fitness do better than statin therapy alone. Another jump on fitness to >9 METs and the reduction in risk is now close to 50%,” Peter F. Kokkinos, PhD, of the cardiology department, Veterans Affairs Medical Center, Washington, D.C., told Cardiology Today.

According to the researchers, this research suggests that statin treatment combined with moderate fitness offers synergistic protection against premature mortality in individuals with dyslipidemia. Lack of fitness, statin treatment or both significantly increased the risk for mortality. For patients unable to take statins, achieving moderate fitness (7 to 9 METs) appears to offer modest protection against premature mortality. Kokkinos recommends brisk walking for 30 minutes most days of the week for this patient population. – by Deb Dellapena

For more information:

Kokkinos PF. Lancet. 2012;doi:10.1016/S0140-6736(12)61426-3.

Disclosure:Kokkinos reports no relevant financial disclosures.