Novaes Caio Eduardo, Rondon Eduardo, Rizzo Caio Fernando Ribeiro, de Oliveira Matheus Oscar, de Souza Francis Ribeiro, Alves Maria-Janieire de Nazaré Nunes, Negrão Carlos Eduardo, Dos Santos Marcelo Rodrigues
Instituto Do Coração (InCor), Hospital Das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Institute of Mathematics and Statistics, Universidade de São Paulo, Brazil.
Int J Cardiol Heart Vasc. 2024 Jul 20;53:101471. doi: 10.1016/j.ijcha.2024.101471. eCollection 2024 Aug.
Cardiovascular disease remains a leading cause of mortality, with statins widely used to reduce its risk. Despite extensive research, the nuanced impact of statin therapy on cardiorespiratory fitness, particularly the reduction in peak oxygen consumption (VO), is still an open question. This study aims to contribute fresh insights to the ongoing discussion, highlighting the unresolved nature of this clinical matter.
We retrospectively analyzed maximal cardiopulmonary exercise test (CPET) in male and female participants over 18 years of age who were under statins treatment. They were categorized as physically active or inactive according to self-report of physical activity. From 33,804 CPET, 4,941 participants (76 % men, age 42 ± 13 years; and 24 % women, age 41 ± 13 years) were included in the study.
The multivariate linear regression model showed that statins were associated with a significant reduction in VO peak (-4.2 [-4.8, -3.5] mL/kg/min, p < 0.01) after adjusting for age, sex, use of beta-blockers, antiarrhythmics, presence of diabetes, and weekly level of physical activity. This reduction in VO peak was attenuated in participants with higher weekly physical activity volume (150 to 300 min/week: 3.2 [2.7; 3.7] mL/kg/min; 301 to 600 min/week: 4.5 [3.7; 5.3] mL/kg/min; and > 600 min/week: 6.9 [5.4; 8.4] mL/kg/min, all p < 0.01).
Statin use is associated with a lower VO peak in adults. However, this adverse effect appears to be mitigated by engaging in regular physical activity (>150 min/week). Future research should explore the mechanisms behind this interaction and identify optimal exercise regimens for individuals on statin therapy.
心血管疾病仍是主要的死亡原因，他汀类药物被广泛用于降低其风险。尽管进行了广泛研究，但他汀类药物治疗对心肺适能的细微影响，尤其是对峰值摄氧量（VO₂）降低的影响，仍是一个悬而未决的问题。本研究旨在为正在进行的讨论提供新的见解，突出这一临床问题尚未解决的本质。
我们回顾性分析了18岁以上接受他汀类药物治疗的男性和女性参与者的最大心肺运动试验（CPET）。根据体力活动的自我报告，将他们分为体力活动活跃或不活跃。从33804次CPET中，4941名参与者（76%为男性，年龄42±13岁；24%为女性，年龄41±13岁）被纳入研究。
多变量线性回归模型显示，在调整年龄、性别、β受体阻滞剂的使用、抗心律失常药物、糖尿病的存在以及每周体力活动水平后，他汀类药物与VO₂峰值显著降低相关（-4.2[-4.8, -3.5]mL/kg/min，p<0.01）。在每周体力活动量较高的参与者中，VO₂峰值的降低有所减弱（每周150至300分钟：3.2[2.7；3.7]mL/kg/min；每周301至600分钟：4.5[3.7；5.3]mL/kg/min；每周>600分钟：6.9[5.4；8.4]mL/kg/min，均p<0.01）。
使用他汀类药物与成年人较低的VO₂峰值相关。然而，通过进行规律的体力活动（每周>150分钟），这种不良影响似乎会减轻。未来的研究应探索这种相互作用背后的机制，并为接受他汀类药物治疗的个体确定最佳运动方案。
