title: The Interaction Between Statins and Exercise: Mechanisms and Strategies to Counter the Musculoskeletal Side Effects of This Combination Therapy.
abstract: BACKGROUND
  Broad indications for the use of statin medications are resulting in more patients using these therapies. Simultaneously, healthcare professionals are strongly advocating recommendations to increase exercise training (ET) as a means of decreasing cardiovascular disease (CVD) risk and improving other parameters of fitness.
  
  
  METHODS
  We review the literature to explore mechanisms that may increase the risk of statin/ET interactions, examine the benefits and risks of combining ET and statin use, and offer strategies to minimize the hazards of this combination therapy.
  
  
  RESULTS
  The combined use of statins and ET can result in health gains and decreased CVD risk; however, multiple factors may increase the risk of adverse events. Some of the events that have been reported with the combination of statins and ET include decreased athletic performance, muscle injury, myalgia, joint problems, decreased muscle strength, and fatigue. The type of statin, the dose, drug interactions, genetic variants, coenzyme Q10 deficiency, vitamin D deficiency, and underlying muscle diseases are among the factors that may predispose patients to intolerance of this combined therapy.
  
  
  CONCLUSIONS
  Effective strategies exist to help patients who may be intolerant of combined statin therapy and ET so they may benefit from this proven therapy. Careful attention to identifying high-risk groups and strategies to prevent or treat side effects that may occur should be employed.
authors.affiliation: Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Deichmann
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Department of Cardiovascular Diseases, John Ochsner Heart & Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Asher
authors.affiliation: Department of Cardiology, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO.
authors.forename: James J
authors.initials: JJ
authors.lastname: DiNicolantonio
authors.affiliation: Department of Cardiology, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO.
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
authors.affiliation: Department of Cardiology, Hartford Hospital, Hartford, CT.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
keywords: Cardiovascular diseases; exercise; hydroxymethylglutaryl-CoA reductase inhibitors