Effect of Antihypertensive and Statin Medication Use on Muscle Performance in Community-Dwelling Older Adults Performing Strength Training

Alturki, Mohammad; Liberman, Keliane; Delaere, Andreas; Dobbeleer, Liza De; Knoop, Veerle; Mets, Tony; Lieten, Siddhartha; Bravenboer, Bert; Beyer, Ingo; Bautmans, Ivan

doi:10.1007/s40266-020-00831-5

Cited by 9 publications

(4 citation statements)

References 53 publications

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“…Evidence is emerging that statins have anti-inflammatory properties, reducing pro-inflammatory cytokine levels [ 32 , 33 ]. A recent secondary analysis of a strength training trial in older adults reported better effect of the training upon fatigue resistance among statin users than among non-users [ 34 ]. When comparing users and non-users of statins, we found a statistically significant difference only for grip strength and only in the unadjusted model.…”

Section: Discussionmentioning

confidence: 99%

Association between statin use and physical performance in home-dwelling older patients receiving polypharmacy: cross-sectional study

et al. 2022

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Background In older patients with polypharmacy and multiple comorbidities, even low grades of statin-associated muscle symptoms may have clinical implications. The aim of this study was therefore to investigate the potential associations between statin use and measures of physical performance and muscle function. Methods Participants were aged 70+, treated with at least seven regular systemic medications, and not expected to die or become institutionalized within 6 months. Physical performance measured as gait speed and Short Physical Performance Battery (SPPB) score, and muscle function measured as grip strength, were compared between users and non-users of statins. In the subgroup of statin users, the dose-response relationship was assessed using harmonized simvastatin equivalents adjusted for statin potency, pharmacokinetic interactions and SLCO1B1 c.521 T > C genotype. Multiple linear regression analyses were applied to investigate potential associations between stain use and exposure as independent variables, and physical performance and muscle function as outcomes, adjusted for age, gender, body mass, comorbidity, disability and dementia. Results 174 patients (87 users and 87 non-users of statins) with a mean (SD) age of 83.3 (7.3) years were included. In analyses adjusted only for gender, grip strength was significantly higher in users than in non-users of statins [regression coefficient (B) 2.7, 95% confidence interval (CI) 1.0 to 4.4]. When adjusted for confounders, the association was no longer statistically significant (B 1.1, 95% CI − 0.5 to 2.7). SPPB and gait speed was also better in statin users than in non-users, but the differences were not statistically significant. In dose-response analyses adjusted for confounders, we found a statistically significant increase in SPPB score (B 0.01, 95% CI 0.00 to 0.02) and gait speed (B 0.001, 95% CI 0.000 to 0.002) per mg increase in simvastatin equivalents. Conclusions In contrast to our hypothesis, statin use and exposure was associated with better measures of physical performance and muscle function in older patients with complex drug treatment. The unexpected findings of this cross-sectional, observational study should be further investigated by comparing physical performance before and after statin initiation or statin withdrawal in prospective studies. Trial registration ClinicalTrials.gov identifier: NCT02379455, registered March 5, 2015.

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Section: Discussionmentioning

confidence: 99%

Association between statin use and physical performance in home-dwelling older patients receiving polypharmacy: cross-sectional study

et al. 2022

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“…On the other hand, Riechman et al reported independent associations of statin use and lean mass increase following a 12-week high intensity resistance exercise training program in healthy older adults ( Riechman et al, 2007 ). Thus, recommendations for continued use of statins during exercise have been made ( Alturki et al, 2021 ). Nevertheless, the lack of randomized trials with healthy control groups, and differences in population-related medical history, statin dose, type of exercise, and performance measures chosen make evidence for statin use during exercise equivocal.…”

Section: Discussionmentioning

confidence: 99%

Potential Benefits of Combined Statin and Metformin Therapy on Resistance Training Response in Older Individuals

et al. 2022

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Metformin and statins are currently the focus of large clinical trials testing their ability to counter age-associated declines in health, but recent reports suggest that both may negatively affect skeletal muscle response to exercise. However, it has also been suggested that metformin may act as a possible protectant of statin-related muscle symptoms. The potential impact of combined drug use on the hypertrophic response to resistance exercise in healthy older adults has not been described. We present secondary statin analyses of data from the MASTERS trial where metformin blunted the hypertrophy response in healthy participants (>65 years) following 14 weeks of progressive resistance training (PRT) when compared to identical placebo treatment (n = 94). Approximately one-third of MASTERS participants were taking prescribed statins. Combined metformin and statin resulted in rescue of the metformin-mediated impaired growth response to PRT but did not significantly affect strength. Improved muscle fiber growth may be associated with medication-induced increased abundance of CD11b+/CD206+ M2-like macrophages. Sarcopenia is a significant problem with aging and this study identifies a potential interaction between these commonly used drugs which may help prevent metformin-related blunting of the beneficial effects of PRT.Trial Registration: ClinicalTrials.gov, NCT02308228, Registered on 25 November 2014.

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“…In the MASTERS trial, metformin has been proved to attenuate muscle hypertrophy in response to resistance training in the elderly population ( Walton et al, 2019 ). On the other hand, the SPRINT trial has demonstrated that exercise training is effective in improving physical function, regardless of whether the participant is a statin and/or antihypertensive user ( Alturki et al, 2021 ).…”

Section: A Brief Look At Nutritional and Medication In Sarcopeniamentioning

confidence: 99%

Anabolic-Androgenic Steroids and Exercise Training: Breaking the Myths and Dealing With Better Outcome in Sarcopenia

2022

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Sarcopenia is an emerging clinical condition determined by the reduction in physical function and muscle mass, being a health concern since it impairs quality of life and survival. Exercise training is a well-known approach to improve physical capacities and body composition, hence managing sarcopenia progression and worsening. However, it may be an ineffective treatment for many elderly with exercise-intolerant conditions. Thus, the use of anabolic-androgenic steroids (AAS) may be a plausible strategy, since these drugs can increase physical function and muscle mass. The decision to initiate AAS treatment should be guided by an evidence-based patient-centric perspective, once the balance between risks and benefits may change depending on the clinical condition coexisting with sarcopenia. This mini-review points out a critical appraisal of evidence and limitation of exercise training and AAS to treat sarcopenia.

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Effect of Antihypertensive and Statin Medication Use on Muscle Performance in Community-Dwelling Older Adults Performing Strength Training

Cited by 9 publications

References 53 publications

Association between statin use and physical performance in home-dwelling older patients receiving polypharmacy: cross-sectional study

Association between statin use and physical performance in home-dwelling older patients receiving polypharmacy: cross-sectional study

Potential Benefits of Combined Statin and Metformin Therapy on Resistance Training Response in Older Individuals

Anabolic-Androgenic Steroids and Exercise Training: Breaking the Myths and Dealing With Better Outcome in Sarcopenia

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