Effect of short-term physical exercise on serum markers of skeletal muscle damage in hypertensive patients treated with a combination of statin and angiotensin-converting enzyme inhibitor

Abstract

Background. Muscle strain during physical exercise may lead to muscle damage and hyperkalaemia. Commonly prescribed drugs including statins and angiotensin-converting enzyme inhibitors (ACEI) may increase serum potassium and cause muscle damage. We postulated that the risk may be even higher if the patients are treated with a combination of statin and ACEI. The aim of the study was to compare the effect of moderate intensity short-term physical exercise on the changes of muscle injury markers serum carbonic anhydrase 3 and creatine kinase in patients with arterial hypertension receiving ACEI and statin. Material and methods. Eighteen patients with arterial hypertension treated with ACEI were included in a prospective placebo-controlled cross-over study. 18 healthy individuals served as controls. Hypertensive patients underwent 30-minute exercise test, which was repeated two times in a random order after the administration of ACEI with statin or ACEI with placebo. Each treatment period lasted 8 weeks separated by 2-week wash-out. Normotensive subjects underwent a single exercise test. Serum carbonic anhydrase 3 (CAIII) and creatine kinase (CK) activity were measured before and after exercise and recovery. Results. At baseline and during the exercise CAIII was significantly higher in healthy volunteers compared to hypertensive patients. CAIII increased significantly during exercise only after treatment with both ACEI and statin. Serum CK was higher in hypertensive patients treated with ACEI plus statin during all exercise tests. Conclusions. Addition of statin to ACEI in patients with arterial hypertension does not increase the risk of muscle damage during moderate intensity short-term physical exercise.