Statins, prescribed for lipid-lowering, reduce cardiovascular disease risk but might negatively impact physical activity and exercise performance. Understanding this impact is crucial for optimizing treatment strategies and promoting patient health. This systematic review was aimed to evaluate the impact of statin use on physical activity levels, exercise performance, and muscle-related outcomes among patients, with a focus on identifying challenges, benefits, and potential mitigation strategies. A systematic search of PubMed, Embase, Scopus, Cochrane Library, and Google Scholar was conducted. Eligible studies included randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in English in the last 10 years. Outcomes assessed included physical activity levels, exercise performance metrics (e.g., endurance and strength) and the incidence of statin-associated muscle symptoms (SAMS). Data were synthesized using a narrative approach, identifying themes, patterns, and gaps in the evidence. A total of 17 studies were included, encompassing diverse populations and methodologies. Key findings revealed mixed outcomes. Symptomatic statin users reported reduced moderate-to-vigorous physical activity and increased sedentary behavior compared to asymptomatic users or nonusers. SAMS, including muscle pain and fatigue, were associated with reduced physical activity in some patients but did not consistently affect exercise performance metrics, such as strength or endurance. Statins do not universally impair physical activity or exercise performance, but SAMS and behavioral factors can limit activity levels in some individuals. Moderate-intensity exercise appears to mitigate adverse effects and enhance overall outcomes. Future research should focus on personalized interventions, long-term impacts, and mechanistic studies to optimize physical activity in statin users.
Key words: Statins, physical activity, exercise performance, statin-associated muscle symptoms, systemic review
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