Cholesterol is a fat-like, waxy substance found in your body and in many foods. It is essential to your body’s ability to function; however, excess, or high, blood cholesterol—whether it results from diet, lifestyle, or genetics—can be hazardous to your health because it can increase the risk of heart disease.
Statins are drugs used to lower blood cholesterol levels, or, specifically, to lower “bad” LDL cholesterol and triglyceride levels and raise “good” HDL levels. The drugs work by lowering LDL cholesterol and slowing down the liver’s production of cholesterol. As well, statins can boost the liver’s ability to remove LDL cholesterol from the blood.
Statins routinely are used for those with high cholesterol and other risk factors for heart disease. In fact, some physicians advocate for their use as preventive medicine in people over 50. However, there is another routine prescription for preventing heart disease: exercise. But if statins undo the benefits of exercise, which is more important: statins or exercise? It turns out, the answer isn’t black and white.
Statins and Exercise
To examine the relationship between statins and exercise, researchers conducted a study in a small group of overweight, sedentary adults at risk of developing high cholesterol or blood pressure. The participants had slightly, but not dangerously, elevated cholesterol levels and none had exercised regularly in the past year. Prior to beginning the study, the participants underwent muscle biopsies and treadmill testing to determine their aerobic fitness levels.
All participants began a supervised 12-week exercise program during which they walked or jogged on a treadmill at a moderately vigorous pace for 45 minutes five days per week. Half the group also began taking statins. At the end of the 12 weeks, the participants were retested. The results showed that the exercise-only group’s aerobic fitness had increased by 10 percent, compared to only 1.5 percent in the statin group. What’s more, the exercise-only group experienced a 13 percent increase in muscle function, whereas the statin group experienced a 4.5 percent decrease in muscle function.
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Interpreting the Results
Both statins and exercise have been shown to be effective in reducing the risk of heart attack among high-risk people, such as those with high cholesterol. But if statins block the benefits of exercise, should people on statins skip exercise? Or should high-risk people skip statins and instead opt for exercise? It’s complicated.
It appears that statins hinder mitochondria production. Mitochondria are the energy-producing parts of cells and typically increase as a result of exercise, which leads to improved fitness. In other words, the group taking statins experienced decreased aerobic rewards for their effort—less bang for the buck. However, the researchers noted that although statins reduced mitochondria production, they didn’t negate all benefits of exercise. The participants were still burning calories, an important component of staying healthy and preventing heart disease.
Statins, Exercise, or Both?
The data from this study is no hall pass to skip exercise—or statins for that matter. Statins have been shown to save lives, especially among those with high cholesterol or a family history of high cholesterol or heart disease. The key is to work with your physician for a balanced, individualized approach. If your cholesterol is borderline or not very high, statins might not be the right approach. Exercise, however, is non-negotiable, as it is an important part of a healthy lifestyle for a variety of reasons.
The researchers speculated that some people might benefit from increasing aerobic fitness prior to beginning statins. Research will likely be ongoing to continue to evaluate the relationship between exercise and statins. In the meantime, it’s important to discuss the optimal approach with your doctor.
Mikus CR, Boyle LJ, Borengasser SJ, et al. Simvastatin impairs exercise training adaptations. The Journal of the American College of Cardiology. Published early online April 10, 2013. doi: 10.1016/j.jacc.2013.02.074