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. 2017 Sep;47(9):1885-1892.
doi: 10.1007/s40279-017-0681-7.

Association Between Statin Use and Prevalence of Exercise-Related Injuries: A Cross-Sectional Survey of Amateur Runners in the Netherlands

Free PMC article

Association Between Statin Use and Prevalence of Exercise-Related Injuries: A Cross-Sectional Survey of Amateur Runners in the Netherlands

Esmée A Bakker et al. Sports Med. .
Free PMC article


Background: HMG-CoA reductase inhibitors (statins) are the first-choice therapy for primary prevention of cardiovascular disease. Some maintain that statins cause adverse musculoskeletal outcomes in highly active individuals, but few studies have examined the effects of statins on exercise-related injuries.

Objective: We sought to compare the prevalence of exercise-related injuries between runners who do or do not use statins.

Methods: Amateur runners (n = 4460) completed an extensive online questionnaire on their exercise patterns and health status. Participants replied to questions on the prevalence of exercise-related injuries in the previous year. Injuries were divided into general injuries, tendon- and ligament-related injuries, and muscle-related injuries. Participants were also queried about statin use: the type of statin, statin dose, and duration of treatment. Runners were divided into statin users, non-statin users with hypercholesterolemia, and controls for analysis.

Results: The crude odds ratios (ORs) for injuries, tendon- or ligament-related injuries, and muscle-related injuries in statin users compared with controls were 1.14 (95% confidence interval [CI] 0.79-1.66), 1.10 (95% CI 0.71-1.72), and 1.15 (95% CI 0.69-1.91), respectively. After adjustment for age, sex, body mass index (BMI), and metabolic equivalent of task (MET) h/week of exercise, the ORs were 1.11 (95% CI 0.76-1.62), 1.06 (95% CI 0.68-1.66), and 0.98 (95% CI 0.58-1.64), respectively. Similar effect measures were found when comparing non-statin users with hypercholesterolemia and controls.

Conclusion: We did not find an association between statin use and the prevalence of exercise-related injuries or tendon-, ligament-, and muscle-related injuries. Runners receiving statins should continue normal physical activity without concern for increased risk of injuries.

Keywords: Atorvastatin; Injury Risk; Rosuvastatin; Statin; Statin User.

Conflict of interest statement

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


The work of TMHE is supported by a European Commission Horizon 2020 Grant (Marie Sklodowska-Curie Fellowship 655502). The work of ST is supported by a ZonMW veni Grant (016.146.118).

Conflict of interest

Esmée A. Bakker, Silvie Timmers, Maria T. E. Hopman, André L. M. Verbeek, and Thijs M. H. Eijsvogels report no conflicts of interest. Paul D. Thompson reports receiving research grants from Aventis, Regeneron, Sanolfi, and Pfizer; serving as a consultant for Aventis, Regeneron, Merck, Genomas, Abbvie, Sanolfi, and Pfizer; receiving speaker honoraria from Regeneron, Sanolfi, Amgen, Aventis, and Merck; owning stock in General Electric, JA Wiley Publishing, J&J, Abbvie, Abbott, Medtronic, and Cryolife.


Fig. 1
Fig. 1
Flowchart of the enrolment of the study population. BMI body mass index, MET metabolic equivalent of task
Fig. 2
Fig. 2
Crude and adjusted odds ratios of total injuries, tendon- or ligament-related injuries, and muscle-related injuries. BMI body mass index, CI confidence interval, HC hypercholesterolemia, MET metabolic equivalent of task, OR odds ratio. *Adjusted for age, sex, BMI, and MET hours per week

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