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High-dose statin use does not impair aerobic capacity or skeletal muscle function in older adults.

ABSTRACT: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are lipid-lowering agents widely employed for atherosclerosis prevention. HMG-CoA reductase blockade reduces skeletal muscle coenzyme Q(10) (CoQ(10)) levels and mitochondrial respiratory chain activities and may produce mild to severe skeletal muscle myopathy. This study investigated whether high-dose statin treatment would result in measurably decreased exercise capacity in older men and women. Maximal oxygen consumption, aerobic endurance, oxygen uptake kinetics, maximal strength, muscular power, and muscular endurance were measured before and after 12 weeks of statin treatment (simvastatin, 80 mg/day) in nine men and one woman, ages 55-76 years, with LDL-cholesterol levels >3.3 mmol/l (mean = 4.2 +/- 0.2 mmol/l). Myalgia symptoms were assessed every 4 weeks. As expected, statin treatment resulted in significant decreases in LDL- and total-cholesterol levels (P < 0.01) with no significant changes in HDL-cholesterol or triglyceride levels. No significant changes were observed in aerobic capacity, endurance, oxygen kinetics or any measures of muscle function. No subject reported symptoms of myalgia, cramps, or weakness during the study. In the absence of myalgia or myopathic symptoms, high-dose simvastatin treatment did not impair exercise capacity in hyperlipidemic older individuals. We conclude that decreases in intramuscular CoQ(10), in most patients on high dose statin treatment may not be clinically relevant, due to inter-individual variability in the degree of CoQ(10) depletion, sensitivity of muscle to decreases in CoQ(10), or both.

SUBMITTER: Traustadottir T

PROVIDER: S-EPMC2585641 | biostudies-other | 2008 Dec

REPOSITORIES: biostudies-other

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Project description:Key pointsHealthy older adults exhibit lower cardiorespiratory fitness ( V̇O2peak ) than young in the absence of any age-related difference in skeletal muscle mitochondrial capacity, suggesting central haemodynamics plays a larger role in age-related declines in V̇O2peak . Total physical activity did not differ by age, but moderate-to-vigorous physical activity was lower in older compared to young adults. Moderate-to-vigorous physical activity is associated with V̇O2peak and muscle oxidative capacity, but physical inactivity cannot entirely explain the age-related reduction in V̇O2peak .AbstractDeclining fitness ( V̇O2peak ) is a hallmark of ageing and believed to arise from decreased oxygen delivery and reduced muscle oxidative capacity. Physical activity is a modifiable lifestyle factor that is critical when evaluating the effects of age on parameters of fitness and energy metabolism. The objective was to evaluate the effects of age and sex on V̇O2peak , muscle mitochondrial physiology, and physical activity in young and older adults. An additional objective was to assess the contribution of skeletal muscle oxidative capacity to age-related reductions in V̇O2peak and determine if age-related variation in V̇O2peak and muscle oxidative capacity could be explained on the basis of physical activity levels. In 23 young and 52 older men and women measurements were made of V̇O2peak , mitochondrial physiology in permeabilized muscle fibres, and free-living physical activity by accelerometry. Regression analyses were used to evaluate associations between age and V̇O2peak , mitochondrial function, and physical activity. Significant age-related reductions were observed for V̇O2peak (P < 0.001), but not muscle mitochondrial capacity. Total daily step counts did not decrease with age, but older adults showed lower moderate-to-vigorous physical activity, which was associated with V̇O2peak (R2 = 0.323, P < 0.001) and muscle oxidative capacity (R2 = 0.086, P = 0.011). After adjusting for sex and physical activity, age was negatively associated with V̇O2peak but not muscle oxidative capacity. Healthy older adults exhibit lower V̇O2peak but preserved mitochondrial capacity compared to young. Physical activity, particularly moderate-to-vigorous, is a key factor in observed age-related changes in fitness and muscle oxidative capacity, but cannot entirely explain the age-related reduction in V̇O2peak .

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High-dose statin use does not impair aerobic capacity or skeletal muscle function in older adults.

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