Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis

Abstract

Background: Statin treatment in association with physical exercise can substantially reduce mortality in dyslipidaemic individuals. However, the available data to compare the efficacy and safety of statins and exercise combination therapy with statin monotherapy are limited. Design: Systematic review and meta-analysis. Methods: We systematically searched PubMed, Embase and the Cochrane Library from database inception until December 2016. We included randomised and non-randomised studies that compared the efficacy and safety of statins and exercise combination therapy with statin monotherapy in patients with dyslipidaemia. Standardised mean differences were calculated and pooled by means of fixed effects models. The risk of bias and heterogeneity among trials was also assessed. Seven articles were assessed in terms of the efficacy of therapy and 13 from the viewpoint of therapeutic safety. Results: In terms of efficacy, statins and exercise combination decreased the incidence of diabetes mellitus, improved insulin sensitivity and inflammation, but caused no change in lipid profile compared to statins alone. In terms of safety, statins and exercise combination increased peak oxygen uptake (standardised mean difference 1.01, 95% confidence interval 0.46 to 1.57) compared to statins alone. In contrast to statin-induced myopathy, chronic exercise training prior to statin treatment could counteract statin-induced adverse effects in skeletal muscle. Conclusion: Statins and exercise combination therapy is more effective than statin monotherapy in terms of insulin sensitivity, inflammation and exercise capacity. The small number of studies warrants the need for more randomised controlled trials evaluating the efficacy and safety of combination therapy.

Impact of educational outreach intervention on enhancing health care providers' knowledge about statin therapy prescribing in Malaysian patients with type 2 diabetes mellitus

“…The lipophilic statins have been associated with higher incidence of muscle‐related symptoms as compared to a hydrophilic statin . It is important for health care providers to consider hydrophilic statin as one of the modalities that can be implemented for patients experiencing muscle‐related side effects of statin therapy …”

WITHDRAWN: Screened microRNAs related to endothelial progenitor cells and verified the target gene of microRNA-126-3p

“…A comprehensive exercise-based CR is safe and beneficial for patients with ASCVD, including those with acute myocardial infarction (AMI) [6,7]. Several randomized trials have verified that aerobic exercise (AE) produced possibly the greatest improvements in peak oxygen consumption (Vo 2 ) and left ventricular ejection fraction [8].…”

Statin combined with exercise training is more effective to improve functional status in dyslipidemic older adults

“…The prescription of ST therapy among older adults is increasing, despite the potential exercise adverse effects that may hinder older adults' ability to participate in exercise training, and may limit numerous exercise‐associated metabolic and functional benefits . Thus, it is fundamental to find effective interventions to reduce physical decline .…”

“…The exact mechanism by which ST+EX promoted functional status improvement is not known but one explanation may be related with the cumulative benefits of EX training in CRF, inflammation, and cardio metabolic parameters combined with the pharmacodynamics effects of ST therapy in the LDL‐C. CRF gains reduce inflammation and improve cardio metabolic parameters, in addition to the exercise capacity and physical functioning . These benefits synergistically promote positive anti‐inflammatory effects and reduced oxidative stress that lead to an improved cardio metabolic system, with important functional status gains in the ST+EX group.…”

“…Therefore, the main goal of this study was to analyze the long‐term (24‐month) effects of three types of treatment (multicomponent exercise training—EX; oral ST; combined therapy including ST plus exercise training—ST+EX) on functional status and on CVR factors including the anthropometric, lipid, and hemodynamic profiles, in independently dyslipidemic older adults with comorbidities. It is hypothesized that the combined therapy would promote more significant benefits due to the synergetic effects of both therapies…”