Abstract
Objective: To establish whether patients receiving the cholesterol synthesis enzyme inhibitor fluvastatin 20 mg/day could obtain an additional improvement in their lipid pattern as a result of physical endurance training.
Design: This was an observational study using a before- and after-treatment comparison of fitness and lipid parameters in outpatients with dyslipidaemia who undertook an exercise programme with or without treatment with a lipid-lowering drug.
Study participants: Participants were 18 sedentary [maximum oxygen uptake (V̇O2max) <30 ml/kg bodyweight per minute] men (age range 38 to 65 years) with dyslipidaemia but without overt cardiovascular disease.
Interventions: All participants undertook a 1-hour bout of endurance training twice a week for 3 months. The training involved a circuit using various ergometers, with continuous monitoring of pulse rate, at an exercise intensity of 2 to 3 mmol/L lactate. The control group (n = 6) received no drug treatment; they completed the training programme only. The pretreatment group (n = 6) comprised participants who had already been treated with fluvastatin 20 mg/day for at least 3 months before beginning the training programme. The treatment group (n = 6) received fluvastatin 20 mg/day from the beginning of the training programme. All participants were required to comply with the exercise programme and with a standardised carbohydrate-loaded diet together with restriction of alcohol consumption to a maximum of 20 ml/day.
Results: In the control group, increased physical activity alone reduced serum triglyceride (TG) levels (−24.7%) and increased serum high density lipoproteincholesterol (HDL-C) levels (+19.3%). There was a smaller effect on serum low density lipoprotein-cholesterol (LDL-C) levels (−12.8%). Similar but smaller effects were observed in the pretreatment group (i.e. patients previously treated with fluvastatin): TG −12.88%, HDL-C +13.81%, LDL-C −8.7%. Marked changes were observed in the treatment group: TG −33.1%, HDL-C +34.7%, LDL−C −40.5%, total cholesterol −30.5%.
Conclusions: A reduction of serum LDL-C level in the target range of −30 to −40% cannot be achieved by this intensity of training alone. In combination with fluvastatin 20 mg/day, however, the positive effects on lipid metabolism are potentiated. Thus, treatment with fluvastatin combined with moderate endurance training is a rational mode of therapy, particularly in patients with a highly pathological lipid profile.
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Wittke, R. Effect of Fluvastatin in Combination with Moderate Endurance Training on Parameters of Lipid Metabolism. Sports Med 27, 329–335 (1999). https://doi.org/10.2165/00007256-199927050-00004
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DOI: https://doi.org/10.2165/00007256-199927050-00004