Findings from a new study published in The Lancet on Nov. 27 suggest that statin treatment and increased fitness can significantly lower mortality in patients with dyslipidaemia when done together or independently. Conversely, the absence of exercise and/or statin treatment increases mortality risks substantially.

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The study, which assessed 10,043 veterans from Veterans Affairs Medical Centers in Palo Alto, CA, and Washington, DC, found that the combination of statins and an exercise capacity of more than 5 metabolic equivalents (MET) lowered mortality risk substantially. While mortality risk overall was lower in people taking statins than in those not taking statins (18.5 percent vs. 27.7 percent, mortality risk decreased even further as fitness increased. The hazard ratio for highly fit individuals (>9 MET; n=694) taking statins was 0.30 compared to a hazard ratio of 1 for least fit (≤5 METs) patients.

For those not taking statins, the hazard ratio progressively decreased as the level of patient fitness increase. Least fit participants not taking statins had a hazard ratio of 1.35 compared to 0.53 for those in the highest fitness category. "The most unfavorable combination was low exercise capacity and lack of statin therapy," the study investigators said.

According to the investigators, the study's finding collectively "suggest that statin treatment combined with moderate fitness offers additional protection against premature mortality in individuals with dyslipidaemia." In addition, they note that the exercise capacity necessary for unfit individuals not on statins to achieve the same or greater results afforded by statin treatment is "moderate and achievable" for many middle-aged and older adults – a finding that suggests improved fitness is an attractive adjunct treatment to statins or an alternative when statins cannot be taken.

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