Statin use does not worsen exercise-induced muscle injury associated with prolonged moderate-intensity exercise, according to a study in the Journal of the American College of Cardiology.

Researchers compared the effects of moderate-intensity exercise on muscle injury in symptomatic and asymptomatic statin users and nonstatin-using control individuals. Statin users had used statins continuously for 3 months or longer before enrollment.

Nonfasting venous blood was drawn at baseline to measure lipid profiles, vitamin D3 concentrations, and muscle injury markers, including lactate dehydrogenase (LDH), creatine kinase (CK), myoglobin, cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP). Postexercise blood samples were obtained within 1 hour of exercise completion on walking days, and coenzyme Q10 (CoQ10) levels were determined in leukocyte mitochondrial fractions. The participants walked 30, 40, or 50 km/d for 4 consecutive days.

Continue Reading

A total of 35 symptomatic statin users, 34 asymptomatic statin users, and 31 nonstatin-using control individuals were included in the study. Symptomatic statin users had a median age of 64 years (80% men) and were younger than asymptomatic statin users (median age, 68 years; 82% men) and control participants (median age, 68 years; 68% men).

Participants’ baseline LDH, CK, myoglobin, cTnI, and NT-proBNP levels were comparable among groups, and those levels increased in all groups after exercise (all, Ptime <.001) although they were not different among groups (all, Ptime × group >.05).

In all groups postexercise, handgrip strength decreased (Ptime <.001), with no differences occurring among groups (Ptime × group =.61). The rate at which muscle peak force declined was significantly increased with exercise (7%±9%), with no differences in the groups.

Half relaxation time among symptomatic statin users increased significantly by 66%±39% (P <.001), increased in asymptomatic statin users by 41%±65% (P =.051), and was unchanged in the control group postexercise (P =.66). The increase in half relaxation time with exercise was significantly greater in symptomatic statin users vs control individuals (P =.035).

At baseline, muscle pain scores were greater for symptomatic statin users vs asymptomatic statin users and control individuals (Pgroup <.001), but they increased similarly after exercise (Ptime <.001) for all groups (Ptime × group =.08).

Symptomatic statin users had greater baseline fatigue scores compared with asymptomatic statin users (Pgroup =.004) and control individuals (Pgroup =.017), and the scores increased similarly with exercise (Ptime <.001) in all groups (Ptime × group =.32).

CoQ10 levels were similar among symptomatic statin users (2.4±0.7 nmol/U), asymptomatic statin users (2.3±0.7 nmol/U), and control individuals (2.1±0.5 nmol/U; P =.20) at baseline. No correlations were found between CoQ10 levels and muscle injury markers at baseline or after exercise (all; P >.05), and no correlations were observed between CoQ10 levels and muscle fatigue resistance or muscle pain scores (all; P >.05)

The investigators noted that their results cannot be applied directly to other exercise modalities and that different findings could occur in participants who are less physically capable, in those with less exercise training, and in those with statin-associated muscle symptoms who had more disabling symptoms. In addition, muscle biopsy specimens were not obtained, and so skeletal muscle mitochondrial function and muscular CoQ10 levels were not directly assessed.

“This study demonstrated that habitually active statin users can engage in prolonged moderate-intensity exercise without exacerbating skeletal muscle injury and reinforces the recommendation to combine statin therapy with a physically active lifestyle,” wrote the study authors. “This is an important strategy in the prevention of cardiovascular diseases.”

Disclosure: One of the study authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Allard NAE, Janssen L, Lagerwaard B, et al. Prolonged moderate-intensity exercise does not increase muscle injury markers in symptomatic or asymptomatic statin usersJ Am Coll Cardiol. Published online April 3, 2023.

This article originally appeared on The Cardiology Advisor