STATINS, MYOPATHY AND PHYSICAL ACTIVITY
DOI:
https://doi.org/10.24193/subbeag.63(4).31Keywords:
exercise training, statins, musculoskeletal, cardiovascular.Abstract
Background: Cholesterol-lowering therapy (statins), associated with lifestyle modifications, have an important role in reducing atherosclerotic cardiovascular disease (ASCVD) events. Methods: We review the literature to explore the mechanisms of myopathy caused by statins and also to examine the effects of combining statin therapy with physical activity. Results: Although statins are usually well tolerated, dose dependent side effects including myopathy and others side effects were reported. Mechanism of myopathy caused by statins is unclear, but there are some theories to explain these. A large number of evidence suggests the protective effect of regular exercise against chronic diseases and this may be mediated trough their anti-inflammatory effect. There are a number of factors (age, genetic factors, vitamin D) influencing the interaction between statins, skeletal muscle and exercise. It is difficult to associate statin therapy with increased aerobic fitness, because of local adverse effects (muscular or hepatic), which tend to decrease patients' physical activity levels. Conclusion: Caution should be taken to the combination of the statin therapy with physical activity, especially in people with increased risk of local effects.
REZUMAT. Statinele, miopatia și activitatea fizică. Introducere: Terapia de reducere a colesterolului (statinele), asociată cu modificări ale stilului de viață, are un rol important în reducerea evenimentelor bolii cardiovasculare aterosclerotice. Metode: Am trecut în revistă datele din literatură pentru a explora mecanismele miopatiei cauzate de statine și totodată pentru a examina efectele combinației terapie cu statine – activitate fizică. Rezultate: Deși statinele sunt în general bine tolerate, s-au raportat efecte adverse legate de doză, incluzând miopatia și alte efecte adverse. Mecanismul miopatiei cauzate de statine este neclar, dar există câteva teorii care să-l explice. Un număr mare de evidențe sugerează efectul protector al exercițiilor fizice regulate împotriva bolilor cronice, iar acesta poate fi mediat prin intermediul efectului lor antiinflamator. Există un număr de factori (vârsta, factorii genetici, vitamina D) care influențează interacțiunea dintre statine, mușchiul scheletic și exercițiile fizice. Este dificil de asociat terapia cu statine cu fitness-ul aerobic crescut, datorită efectelor adverse locale (musculare sau hepatice), care tind astfel să scadă nivelele de activitate fizică ale pacienților. Concluzii: Trebuie acordată o atenție deosebită combinării terapiei cu statine cu activitatea fizică, în special la persoanele cu risc crescut de efecte adverse locale.
Cuvinte cheie: antrenament fizic, statine, musculoscheletal, cardiovascular.
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