Uncovering the Relationship between Statins and Muscle Problems in the ELSA-Brasil MSK Cohort

Abstract

Purpose. To investigate the association between statins and muscle problems in a highly diverse sample of Brazilian civil servants. Methods. We conducted a cross-sectional data analysis at baseline of the ELSA-Brasil MSK cohort. Pain was identified through self-reported symptoms in large muscle groups (lower back and/or hips/thighs). Muscle strength was assessed using the five-times-sit-to-stand (FTSTS) and handgrip tests, with weakness defined as the lowest and highest quintiles of age− and sex−stratified handgrip strength and FTSTS performance time, respectively. Multivariable logistic regression analyses were conducted to investigate the association between statin use and muscle pain and weakness. Secondary analyses explored the impact of different types of statins and their duration of use on the response variables. Results. A total of 2,156 participants (mean age 55.6 ± SD 8.9, 52.8% women) were included. We found no significant association between statin use and muscle problems. Secondary exploratory analysis on different types of statins revealed an association between atorvastatin and muscle weakness, as measured by the five-times-sit-to-stand test (OR 1.94 IC95% 1.12–3.37), but not by the handgrip test (OR 0.75 IC95% 0.29–1.42). No evidence was found to support a link between the duration of statin treatment and muscle problems. Conclusions. This study challenges previous claims of an efficacy-effectiveness gap between experimental and observational literature on statins, offering important insights into the widespread prescription of statins in diverse populations. The findings indicate that statin use does not contribute to muscular problems.