Lower energy, more exertional fatigue with statins

Statin treatment was associated with less energy and more exertional fatigue, according to a recent analysis.

Researchers used data from the University of California, San Diego Statin Study, which included 1,016 patients with low-density lipoprotein levels of 115 to 190 mg/dL and no cardiovascular disease or diabetes. The patients were randomized to daily 20-mg simvastatin, 40-mg pravastatin or placebo. The study participants rated their own change in energy and fatigue with exertion after six months of therapy. The results were published as an online research letter by the Archives of Internal Medicine on June 11.

The study found a significantly larger drop in energy among statin users compared to placebo recipients. The authors used patients' self-ratings to create an energy/exertional fatigue score, and they found a mean drop of −0.21 (P=0.005) in statin patients. Women had an even greater decrease in their mean scores (−0.39, P=0.01). The authors explained that such a drop could indicate 4 in 10 statin-taking women having worsening energy or fatigue, 2 in 10 finding either marker to be worse or much worse, or 1 in 10 having much worse energy and fatigue. Simvastatin appeared to be associated with greater mean drops in the energy/fatigue score than pravastatin.

The findings support previous case reports of statin side effects, the authors concluded. These effects could be important in statin-prescribing decisions, especially for healthier patients who have less expected benefit from the drugs. Lower levels of activity and exertional tolerance could lead to other adverse effects, the authors noted. They called for long-term trials to gather additional evidence and urged physicians to be alert to statin-taking patients' reports of worsened energy and fatigue.