Bosomworth N John
From the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
J Am Board Fam Med. 2016 Nov 12;29(6):727-740. doi: 10.3122/jabfm.2016.06.160085.
This review aims to determine whether active adults who begin statins and develop myalgia reduce or stop activity to become less symptomatic. If this occurs, strategies to mitigate symptoms are explored. Should these strategies fail, the question of whether exercise is an adequate alternative to statin therapy is addressed.
PubMed, Google Scholar, and the Cochrane Database were searched with keywords designed to retrieve information on statin myopathy in exercising adults.
Statins are well tolerated by most people who exercise; however, caution is warranted in those who exercise at high levels, in the elderly, and in those receiving high-dose therapy. Several strategies improve statin tolerance while maintaining exercise levels, based on low-quality evidence. If statins are not tolerated, a continuing physical activity program can provide equivalent or superior cardiometabolic protection.
Statins may occasionally present a barrier to physical activity. A number of strategies exist that can reduce the risk of myopathy. If a choice between exercise and statins becomes necessary, exercise provides equal benefit in terms of cardiovascular protection and superior mortality reduction, with improved quality of life.
本综述旨在确定开始服用他汀类药物并出现肌痛的活跃成年人是否会减少或停止活动以减轻症状。如果出现这种情况，将探索减轻症状的策略。如果这些策略失败，将探讨运动是否是他汀类药物治疗的适当替代方法。
使用旨在检索有关运动成年人他汀类药物肌病信息的关键词，对PubMed、谷歌学术和考克兰数据库进行了搜索。
大多数运动的人对他汀类药物耐受性良好；然而，对于高强度运动的人、老年人以及接受高剂量治疗的人，需要谨慎使用。基于低质量证据，有几种策略可在维持运动水平的同时提高他汀类药物耐受性。如果他汀类药物不耐受，持续的体育活动计划可提供同等或更好的心脏代谢保护。
他汀类药物偶尔可能会对身体活动造成障碍。有多种策略可降低肌病风险。如果必须在运动和他汀类药物之间做出选择，运动在心血管保护方面具有同等益处，在降低死亡率方面效果更佳，且能改善生活质量。
