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Exercise could help thousands of patients taking statins from suffering muscle pain

Moderate exercise could help patients taking cholesterol-busting statins beat the most common side effect of muscle pain, researchers say

  • Roughly six million people in Britain take statins at a cost of £20 per patient
  • Between 15 and 20% of patients who take them report some form of muscle pain
  • Discovery could lead to ways to stop scores of patients giving up on the drugs 

Moderate exercise may be the antidote to the most common side effect of statins, researchers believe.

Thousands of patients taking the cholesterol-busting pills experience muscle pain after taking the medications.

And scientists now claim they know why, in a breakthrough that could lead to ways to stop scores of patients giving up on the life-saving drugs. 

Thousands of patients taking the cholesterol-busting pills experience muscle pain after taking the medications

Roughly six million people in Britain take statins, preventing 80,000 heart attacks and strokes every year at the cost of roughly £20 a year per patient.

Many others start taking the drugs but stop – with between 15 and 20 per cent of patients reporting some form of muscle pain.

Doctors believe tens of thousands of people die in Britain every year because they shun the life-saving pills, often due to side effects.

The researchers at the University of Leeds and the Karolinska Institute in Sweden found statins can cause spontaneous leaks of calcium from storage compartments within muscle cells. 

Unregulated calcium leaks may cause damage to muscle cells, potentially leading to muscle pain and weakness.

In most people, muscle cells can tolerate this calcium leak, the study funded by the British Heart Foundation suggested. 

But in people already susceptible due to their genes or lifestyle, it could overwhelm the muscle cells, causing muscle pain and weakness.

WHY ARE STATINS CONTROVERSIAL? 

Statins are the most commonly prescribed drug in the world and an estimated 30 per cent of all adults over the age of 40 are eligible to take them.

The cholesterol-lowering drugs are given to people believed to have a 10 per cent or higher risk of developing cardiovascular disease or having a heart attack or stroke within the next 10 years.

They are proven to help people who have suffered heart problems in the past, but experts say the thresholds may be too high, meaning benefits are outweighed by side effects for many people.

Nearly all men exceed the 10 per cent threshold by age 65, and all women do so by age 70 – regardless of their health.

Commonly reported side effects include headache, muscle pain and nausea, and statins can also increase the risk of developing type 2 diabetes, hepatitis, pancreatitis and vision problems or memory loss.

Research published in the Pharmaceutical Journal last year found taking a daily statin for five years after a heart attack extends your life by just four days, new research reveals.

And Dr Rita Redberg, professor at the University of California, San Francisco told CNN in January that of 100 people taking statins for five years without having had a heart attack or stroke, ‘the best estimates are that one or two people will avoid a heart attack, and none will live longer, by taking statins.

The team of scientists said their findings suggest why only some people experience muscle pain after taking statins.

The researchers also showed that exercise may prevent the changes which lead to calcium leaks from occurring.

And it may be an effective way for people taking statins to avoid muscle symptoms, they wrote in JACC: Basic to Translational Science.

The team tested the effects of statins on muscle biopsies from patients taking statins long term, and from rats treated with statins for four weeks.

They found statins compromised gatekeeper proteins called ryanodine receptors, which control calcium release from storage compartments in muscle cells.

This resulted in spontaneous and irregular calcium leaks that could trigger signals promoting cell death.

These pro-death signals were elevated in muscles from both people and rats treated with statins compared to untreated controls.

However, statins did not affect muscle function or strength in the rats, despite the cell changes, the scientists found.

They said the research also suggests the potentially harmful effects of statins on muscle can be countered with exercise.

When rats were given free access to an exercise wheel, the statin-related changes to the gatekeeper proteins no longer occurred. 

The team of researchers also observed that rats treated with statins ran twice as far as control rats.

Professor Metin Avkiran, associate medical director at the BHF, said: ‘Statins are life-saving drugs and most people who take them don’t experience side effects.

‘Those who do suffer muscle pain and weakness should always ask their doctor if a different statin or dose might solve the problem.

‘Identifying how statins affect muscle cell biology is the first step in preventing potential muscle side effects – and ensuring that people who are susceptible to those side effects do not miss out on the protection afforded by statins.’

The researchers acknowledge they did not directly show that the cell changes lead to muscle weakness and pain in people, but note that this is likely.

The proposed mechanism may also explain why heart muscle, which has different gatekeeper proteins for calcium release, is protected from any potentially harmful effects of statins.  

HOW MUCH EXERCISE DO YOU NEED TO DO?

To stay healthy, adults aged 19 to 64 should try to be active daily and should do:

  • at least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week and
  • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)

Or:

  • 75 minutes of vigorous aerobic activity such as running or a game of singles tennis every week and
  • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)

Or:

  • a mix of moderate and vigorous aerobic activity every week – for example, 2 x 30-minute runs plus 30 minutes of brisk walking equates to 150 minutes of moderate aerobic activity and
  • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)

A good rule is that 1 minute of vigorous activity provides the same health benefits as 2 minutes of moderate activity.

One way to do your recommended 150 minutes of weekly physical activity is to do 30 minutes on 5 days every week.

All adults should also break up long periods of sitting with light activity.

Source: NHS 



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