Statins for primary prevention in physically active individuals: Do the risks outweigh the benefits?

OBJECTIVES: There are little data on the potential benefits and adverse events of statins among physically fit individuals. Our objective was to examine the associations of statin use with beneficial cardiovascular outcomes and adverse events in active duty military (a surrogate for high level of physical fitness).

DESIGN: This is a retrospective propensity score-matched cohort study of healthy active duty military (fiscal years [FY] 2002-2011).

METHODS: Statin-users received statins during FY 2005 as their only prescription medication. FY 2002-2004 was used to describe baseline characteristics; and FY 2006-2011were used to capture outcomes. Study outcomes included major acute cardiovascular events (MACE), diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, and malignancy.

RESULTS: We propensity score matched 837 statin-users to 2488 nonusers. During follow-up, 1.6% statin-users and 1.5% nonusers were diagnosed with MACE (odds ratio [OR] 1.05, 95% confidence interval [CI] 0.55-1.98), 12.5% of statin-users and 5.8% of nonusers were diagnosed with diabetes (OR 2.34, 95% CI 1.79-3.04), and 1.7% statin- users and 0.7% nonusers were diagnosed with diabetes with complication (OR 2.47, 95% CI 1.21-5.04). There were no differences in rates of other adverse events.

CONCLUSIONS: Among healthy physically active individuals, statin use was associated with doubled the odds of diabetes and diabetic complications without countervailing cardiovascular benefits.