title: Statins for primary prevention in physically active individuals: Do the risks outweigh the benefits?
abstract: OBJECTIVE
  There are little data on the potential benefits and adverse events of statins among physically fit individuals. Our objective was to examine the associations of statin use with beneficial cardiovascular outcomes and adverse events in active duty military (a surrogate for high level of physical fitness).
  
  
  METHODS
  This is a retrospective propensity score-matched cohort study of healthy active duty military (fiscal years [FY] 2002-2011).
  
  
  METHODS
  Statin-users received statins during FY 2005 as their only prescription medication. FY 2002-2004 was used to describe baseline characteristics; and FY 2006-2011were used to capture outcomes. Study outcomes included major acute cardiovascular events (MACE), diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, and malignancy.
  
  
  RESULTS
  We propensity score matched 837 statin-users to 2488 nonusers. During follow-up, 1.6% statin-users and 1.5% nonusers were diagnosed with MACE (odds ratio [OR] 1.05, 95% confidence interval [CI] 0.55-1.98), 12.5% of statin-users and 5.8% of nonusers were diagnosed with diabetes (OR 2.34, 95% CI 1.79-3.04), and 1.7% statin- users and 0.7% nonusers were diagnosed with diabetes with complication (OR 2.47, 95% CI 1.21-5.04). There were no differences in rates of other adverse events.
  
  
  CONCLUSIONS
  Among healthy physically active individuals, statin use was associated with doubled the odds of diabetes and diabetic complications without countervailing cardiovascular benefits.
authors.affiliation: Department of Medicine, VA North Texas Health Care System, United States; Departments of Internal Medicine, University of Texas Southwestern Medical Center, United States; Departments of Clinical Sciences, University of Texas Southwestern Medical Center, United States. Electronic address: ishak.mansi@va.gov.
authors.forename: Ishak A
authors.initials: IA
authors.lastname: Mansi
authors.affiliation: Patient Administration Systems & Biostatistics Activity (PASBA), MEDCOM Head Quarter, JBSA Fort Sam, United States.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: English
authors.affiliation: Pulmonary/Critical Care Service, Department of Medicine, San Antonio Military Medical Center, JBSA Fort Sam, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Morris
authors.affiliation: Departments of Clinical Sciences, University of Texas Southwestern Medical Center, United States.
authors.forename: Song
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Medicine, VA North Texas Health Care System, United States; Departments of Internal Medicine, University of Texas Southwestern Medical Center, United States; Departments of Clinical Sciences, University of Texas Southwestern Medical Center, United States.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
authors.affiliation: Departments of Internal Medicine, University of Texas Southwestern Medical Center, United States; Departments of Clinical Sciences, University of Texas Southwestern Medical Center, United States.
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Halm
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D016017:Odds Ratio; D011322:Primary Prevention; D057216:Propensity Score; D012189:Retrospective Studies; D057185:Sedentary Behavior
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Diabetes; Diabetic complications; Physical activity; Primary prevention; Statin