Association of statins with peak oxygen consumption in 4,941 adults: A cross-sectional study

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 (VO₂), 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 VO₂ 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 VO₂ 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 VO₂ 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.