News Review From Harvard Medical School -- Statins Plus Exercise Better Than Each Alone
Taking statin drugs and also exercising may reduce the risk of early death up to 70%, a new study finds. That finding comes from a study of 10,000 veterans. All had high LDL ("bad cholesterol") and received care at a U.S. veterans' hospital. Nearly all of them were men. Everyone took a treadmill test to assess fitness. Researchers looked at people's medical records and kept track of people for 10 years. Those who took statins were 35% less likely to die during the study than people who did not take these drugs. Statins reduce LDL and inflammation. Death rates were 70% lower for people who had the highest fitness level and also took statins than for those who did neither. The fittest people had 60% lower death rates even if they did not take statins. These drugs include Lipitor (atorvastatin), Lescol (fluvastatin), Pravachol (pravastatin), Crestor (rosuvastatin) and Zocor (simvastatin). The journal Lancet published the study online. HealthDay News wrote about it November 27.
By Reena L. Pande, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
I am a firm believer in the benefits of exercise. I believe in it so much that I get out of bed in the dark hours of the morning before the rest of my family is even awake. I strap on my headlamp and head out for a morning run.
Here are some reasons that exercise is so good for you:
- Improved fitness level
- Lower cholesterol
- Improved blood pressure
- Better blood sugar control
- Reduced weight
- Lower stress
- Lower risk of heart disease
You also just plain feel better about yourself when you exercise.
I am also a firm believer in the benefits of statins -- for my patients, that is. These drugs go by the generic names atorvastatin, simvastatin, rosuvastatin and several others. Statins have several helpful effects, including:
- Lower LDL ("bad cholesterol") levels
- Lower risk of having a heart attack
- Lower risk of having a stroke
- Lower risk of dying
The benefits are substantial both in people with heart disease and in those who are healthier.
A new study out this week shows that exercise and statins are even better for people with high cholesterol when they are used together.
The study kept track of more than 10,000 male veterans with high cholesterol. Some were taking a statin. Some were not. Some were physically fit. Some were not. They were followed for an average of 10 years. What did we learn from this study?
- Exercise is really good for you, whether you take pills to lower your cholesterol or not.
- Statins are also really good for you and clearly lowered the risk of dying in these patients.
- The people who were taking statins and who were the most physically fit did the best overall. They were also the least likely to die.
- The combination of exercise and statin treatment was a lot better than either one alone.
What Changes Can I Make Now?
Shockingly, few people engage in regular physical activity. Here's what I recommend.
- Just do something. Find an activity you enjoy. If you don't like to jog, don't jog. Perhaps you like to dance, hike, ride a bike or take a Zumba class. Whatever it is, just do what you love.
- Meet the guidelines. The official advice for how much exercise you should get in a week is at least 150 minutes of moderate activity. This includes brisk walking, leisurely cycling or raking leaves. Or you can choose 75 minutes per week of vigorous activity. Examples include running, aerobics, competitive sports, fast cycling or swimming.
- Cold is no excuse. Lots of my patients tell me they'll start walking when the weather is better. If it's cold where you live, here are some ideas to try. Walk in the mall, climb stairs in your building or join a gym. Or you can do what I do: Just bundle up and get out there. You will never feel prouder of yourself than when you return from exercising in the bitter cold!
Whether you should be taking a statin requires a discussion between you and your doctor. Statins are especially recommended for people with heart disease, diabetes and high cholesterol. Statins may also be appropriate for some people who don't have these diseases but may be at high risk.
Statins can have some side effects. A small number of people cannot tolerate taking them because of muscle aches or liver problems. There have also been some issues raised recently about a risk of diabetes and memory problems with statins. I believe that these risks are low and that the benefits in most people will outweigh the risks. Talk to your doctor to see if you should be taking a statin.
What Can I Expect Looking to the Future?
There is really no debate about the benefits of exercise. The challenge that remains is finding the will to do it. Future research will no longer be focused on whether it's good but how to make it happen.
Perhaps doctors will be doling out "prescriptions" for exercise. Or maybe patients will get wireless devices along with their medicines so that they can track their activities. The trackers also will let doctors and others know that they have been exercising. It could be similar to tracking your blood sugar if you have diabetes. We need new approaches that will help and motivate people to start exercising and keep exercising.