If statins can reduce cardiovascular risk and overall mortality, as shown in large clinical trials, is it really worth the extra effort to also maintain a healthy lifestyle—especially when it comes to exercise? We know that physical fitness is associated with reduced mortality. But how pronounced is the fitness benefit if you are a statin user?
To answer that question, researchers at George Washington University in Washington, DC looked at medical records of more than 10,000 military veterans (most of them men) with elevated cholesterol. Half the subjects were statin users and half were not. All the subjects (average age 59) had undergone exercise tolerance tests between 1986 and 2011, and the researchers used the test results to assign subjects into fitness categories. They then tracked mortality rates over a 10-year period.
Their conclusion, published in 2013 in The Lancet, was that statin use and increased fitness together resulted in substantially lower mortality risk than either alone. In the statin group, the fittest subjects had a 70 percent lower mortality risk compared with the least fit subjects. One striking finding: The highly fit nonstatin users had a significantly lower risk of death than unfit statin users.
The study didn’t measure whether fitness levels were consistently maintained over time. But for people who are not fit, said the researchers, moderate-intensity activities such as walking, biking and gym classes should provide cardio-protection equivalent to or even greater than that achieved by statin treatment.