When it comes to cardiovascular health, following a healthy lifestyle is always important. That’s true even if you take cholesterol-lowering statins. Experts stress that statins, exercise and a heart-healthy diet are great partners in your efforts to improve and maintain heart health.
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Cardiologist Michael Rocco, MD, Medical Director of Cardiac Rehabilitation and Stress Testing in Preventive Cardiology at Cleveland Clinic, says, “Statins are great; exercise is, too. Together, they form a powerful ally in the fight against heart disease.”
Does statin use give patients a false sense of security?
Some experts question just how effective statins are in improving the overall health of patients. They asked whether taking a heart protective pill might cause muscle aching or somehow lull people into a false sense of security, pushing exercise to the back burner.
A prospective observational study in JAMA recently found that statin users had a modestly lower level of exercise capacity than people who didn’t take statins. Dr. Rocco didn’t participate in the study. But he notes, “Both groups reported some decline in capacity over time, but the small difference is unlikely to offset the benefits of statin therapy in appropriate patients. The verdict is out whether the difference is due to statin primarily to induced muscle symptoms.”
Other research claims that statin users consume more calories and fat than people who don’t take statins. A survey of data from the National Health and Nutrition Examination Survey (NHANES) noted that statin users had a greater increase in calorie and fat consumption as compared with non-statin users over a 10-year follow-up.
But the reasons behind the numbers aren’t so clear, says Dr. Rocco. He points out, “Individuals in the study who were on statins were also more likely to be older, overweight and have diabetes, which needs consideration.” Perhaps a relying on the protective effects of the medication resulted in less vigilance with diet.”
Possible concerns about statins and blood sugar levels
Some studies find links between high-dose statins and higher blood sugar levels or new-onset diabetes. Again, Dr. Rocco points out the complexities. “Research of this type can suggest associations but causality is not conclusive. It is also important to note that patients who developed diabetes were those who already had risk factors for diabetes: elevated baseline blood sugar, excess weight and a sedentary lifestyle.”
Lifestyle before and after statins is a key factor in health
Maintaining a healthy lifestyle by exercising regularly and eating a healthy diet gives you a great start to heart health before you ever take statins. And maintaining that healthy lifestyle is just as important, perhaps more important, after you start taking statins. Dr. Rocco says, “While statins are effective and safe in reducing dangerously high levels of LDL cholesterol and reducing heart attack and stroke in high risk individuals, I sometimes worry that some patients and doctors might develop a false sense of security and rely solely on statins to ensure cardiovascular health. We have to continually remind our patients that exercise and diet plus statins are greater than the sum of each individual part.”
The big picture
Dr. Rocco reminds everyone that while pills are appropriate in many patients, they don’t fix everything.
“Statin therapy does not mean healthy lifestyle changes can be ignored. As physicians, we should stress the importance of exercise and dietary interventions before and after prescribing statin therapy.”