Shoulder muscle pain

A recent study found that statins treatment did not worsen muscle injury, pain, or fatigue during moderate-intensity exercise, allowing statin users to safely maintain an active lifestyle and benefit from improvements in cardiovascular health.

statins do not increase muscle soreness after prolonged walking, which is important for heart health in statins users.

A study published in the Journal of the American College of Cardiology found that statin therapy did not aggravate muscle injury, pain, or fatigue in individuals participating in moderate-intensity exercise, such as walking. Researchers compared the effects of moderate exercise on muscle injury in symptomatic and asymptomatic statin users and non-statin using controls, and found no significant differences between the two groups. The study concluded that prolonged, moderate-intensity exercise is safe for statins users, allowing them to maintain an active lifestyle and reap the cardiovascular health benefits. No association was found between CoQ10 levels in white blood cells and markers of muscle injury or muscle pain scores.

Statin therapy does not worsen muscle injury, pain, or fatigue in people who do moderate-intensity exercise, such as walking, according to a study published April 3 in the Official Journal. Journal of the American College of Cardiology. The results are reassuring for people who experience muscle aches or fatigue from statins but need physical activity to keep their cholesterol levels low and their hearts healthy.

Statins have long been the gold standard for lowering LDL or “bad” cholesterol and preventing cardiovascular disease (CVD) events, but although they are generally well tolerated, they can cause muscle aches and weakness in some. Physical activity is also a cornerstone of CVD prevention, especially when combined with statins; However, studies have shown that vigorous exercise can increase muscle damage in some statin users, which may lead to decreased physical activity or cause people to stop taking their medication. Not much is known about the effect of moderate exercise.

Researchers sought to compare the effect of moderate-intensity exercise on muscle injury in symptomatic and asymptomatic statin users, as well as non-statin using controls. Symptomatic versus asymptomatic symptoms were defined by the presence, localization, and onset of muscle spasms, pain, and/or weakness using the statin index score for clinical myalgia. The researchers also examined the relationship between CoQ10 levels in white blood cells in muscle injury and muscle complaints, since statins may lower CoQ10 levels and low levels can predispose people to muscle injury.

All study participants walked 30, 40, or 50 kilometers (18.6, 24.8, or 31 miles, respectively) per day at a self-selected pace for four consecutive days. All statin users have been on the drug for at least three months. The researchers excluded patients with diabetes, hypo or hyperthyroidism, known hereditary skeletal muscle defects, other diseases known to cause muscular symptoms or those using CoQ10 supplements. There were no differences in body mass index, waist circumference, physical activity levels, or vitamin D3 levels (low levels of vitamin D3 have been associated with statin-induced myopathy and thus may be a risk factor for statin-related muscle symptoms) between the three. Basically groups.

The researchers found that statins did not worsen muscle injury or muscle symptoms after moderate-intensity exercise.

“Although scores for muscle pain and fatigue were higher in symptomatic statin users at baseline, the increase in muscle symptoms after exercise was similar,” said Neltje Allard, MD, first author of the study and a researcher in the Department of Integrative Physiology. between groups”. Radboud University Medical Center Nijmegen, The Netherlands. “These findings demonstrate that prolonged moderate-intensity exercise is safe for statins users and can be performed by statins users to maintain a physically active lifestyle and derive its cardiovascular health benefits.”

The researchers did not find a relationship between CoQ10 levels in white blood cells and markers of muscle injury at baseline or after exercise, nor was there a correlation between CoQ10 levels and muscle fatigue resistance or muscle soreness scores.

In an accompanying editorial commentary, Robert Rosenson, MD, director of metabolism and lipids at Mount Sinai Health System in New York, said patients with statin-related muscle symptoms will often avoid exercise because of muscle pain and weakness and concerns about making the pain worse. ; However, exercise is essential for restoring and maintaining physical fitness in people who are at increased risk of cardiovascular disease or who have had cardiovascular disease.

“[Based on the study]Many patients who develop statin-related muscular symptoms may engage in a fairly intense walking program without concern of deterioration in biomarkers or muscular performance.”

Reference: “Prolonged-intensity exercise does not increase markers of muscle injury in symptomatic or asymptomatic statin users” by Neeltje AE Allard, Lando Janssen, Bart Lagerwaard, Malou AH Nuijten, Coen CWG Bongers, Richard J. Rodenburg, Paul D. Thompson Thijs MH Eijsvogels, Willem JJ Assendelft, Tom JJ Schirris, Silvie Timmers and Maria TE Hopman, April 3, 2023, Available here. Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2023.01.043

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