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Prevalence of Musculoskeletal Pain and Statin Use

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Abstract

Background

Muscle effects are the most common reported adverse effects of 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins). However, in placebo-controlled trials the incidence of muscle pain is most often similar for placebo and active control groups.

Objective

We sought to evaluate whether statin use was associated with a higher prevalence of musculoskeletal pain in a nationally representative sample.

Methods

Cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002. Participants were 3,580 adults ≥40 years without arthritis who were interviewed at home and examined in a mobile examination center. Participants were asked about sociodemographic characteristics, health conditions, medication use, and musculoskeletal pain. Height, weight, blood pressure, ankle brachial index, and cholesterol were measured.

Measurements and Main Results

Prevalence and adjusted odds ratios (OR) of any musculoskeletal pain and musculoskeletal pain in 4 different anatomical regions (neck/upper back, upper extremities, lower back, and lower extremities) by statin use during the last 30 days. Among statin users (n = 402), 22.0% (95%CI 18.0–26.7%) reported musculoskeletal pain in at least 1 anatomical region during the last 30 days, compared with 16.7% (95%CI 15.1–18.4%) of those who did not use a statin. Compared to persons who did not use statins, those who used statins had multivariable-adjusted odds ratios (95%CI; p value) of 1.50 (1.07–2.11; p = .01) for any musculoskeletal pain, 1.59 (1.04–2.44, p = .03) for lower back pain, and1.50 (1.02–2.22, p = .03) for lower extremity pain.

Conclusion

Musculoskeletal pain is common in adults ≥40 years without arthritis. In this nationally representative sample, statin users were significantly more likely to report musculoskeletal pain.

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References

  1. Mitka M. Expanding statin use to help more at-risk patients is causing financial heartburn. JAMA. 2003;290(17):2243–5.

    Article  PubMed  CAS  Google Scholar 

  2. Cannon CP, Steinberg BA, Murphy SA, Mega JL, Braunwald E. Meta-analysis of cardiovascular outcomes trials comparing intensive versus moderate statin therapy. J Am Coll Cardiol. 2006;48(3):438–45.

    Article  PubMed  CAS  Google Scholar 

  3. Fonarow GC, Watson KE. Effective strategies for long-term statin use. Am J Cardiol. 2003;92(1A):27i–34i.

    Article  PubMed  Google Scholar 

  4. Black DM. A general assessment of the safety of HMG CoA reductase inhibitors (statins). Curr Atheroscler Rep. 2002;4(1):34–41.

    Article  PubMed  Google Scholar 

  5. Sacks FM. Adherence to statin therapy: why aren’t we doing better? Am J Med. 2002;113(8):685–6.

    Article  PubMed  Google Scholar 

  6. Thompson PD, Clarkson PM, Rosenson RS. An assessment of statin safety by muscle experts. Am J Cardiol. 2006;97(8A):69C–76C.

    Article  PubMed  CAS  Google Scholar 

  7. McKenney JM, Davidson MH, Jacobson TA, Guyton JR. Final conclusions and recommendations of the National Lipid Association Statin Safety Assessment Task Force. Am J Cardiol. 2006;97(8A):89C–94C.

    Article  PubMed  CAS  Google Scholar 

  8. Pasternak RC, Smith SC Jr., Bairey-Merz CN, Grundy SM, Cleeman JI, Lenfant C. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. J Am Coll Cardiol. 2002;40(3):567–72.

    Article  PubMed  Google Scholar 

  9. Armitage J. The safety of statins in clinical practice. Lancet. 2007;370(9601):1781–90.

    Article  PubMed  CAS  Google Scholar 

  10. de Sauvage Nolting PR, Buirma RJ, Hutten BA, Kastelein JJ. Two-year efficacy and safety of simvastatin 80 mg in familial hypercholesterolemia (the Examination of Probands and Relatives in Statin Studies with Familial Hypercholesterolemia [ExPRESS FH]). Am J Cardiol. 2002;90(2):181–4.

    Article  PubMed  Google Scholar 

  11. Bruckert E, Hayem G, Dejager S, Yau C, Begaud B. Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients—the PRIMO study. Cardiovasc Drugs Ther. 2005;19(6):403–14.

    Article  PubMed  CAS  Google Scholar 

  12. Franc S, Dejager S, Bruckert E, Chauvenet M, Giral P, Turpin G. A comprehensive description of muscle symptoms associated with lipid-lowering drugs. Cardiovasc Drugs Ther. 2003;17(5–6):459–65.

    Article  PubMed  CAS  Google Scholar 

  13. National Center for Health Statistics, National Health and Nutrition Examination Survey Institutional Review Board Approval. (Accessed April 18, 2007, at http://www.cdc.gov/nchs/about/major/nhanes/intro_mec.htm).

  14. Kashani A, Phillips CO, Foody JM, et al. Risks associated with statin therapy: a systematic overview of randomized clinical trials. Circulation. 2006;114(25):2788–97.

    Article  PubMed  CAS  Google Scholar 

  15. Jukema JW, Bruschke AV, van Boven AJ, et al. Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). Circulation. 1995;91(10):2528–40.

    PubMed  CAS  Google Scholar 

  16. Hunninghake DB, Stein EA, Dujovne CA, et al. The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia. N Engl J Med. 1993;328(17):1213–9.

    Article  PubMed  CAS  Google Scholar 

  17. Davidson M, Ma P, Stein EA, et al. Comparison of effects on low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with rosuvastatin versus atorvastatin in patients with type IIa or IIb hypercholesterolemia. Am J Cardiol. 2002;89(3):268–75.

    Article  PubMed  CAS  Google Scholar 

  18. Kerzner B, Corbelli J, Sharp S, et al. Efficacy and safety of ezetimibe coadministered with lovastatin in primary hypercholesterolemia. Am J Cardiol. 2003;91(4):418–24.

    Article  PubMed  CAS  Google Scholar 

  19. MRC/BHF. Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360(9326):7–22.

    Article  Google Scholar 

  20. Blankenhorn DH, Azen SP, Kramsch DM, et al. Coronary angiographic changes with lovastatin therapy. The Monitored Atherosclerosis Regression Study (MARS). Ann Intern Med. 1993;119(10):969–76.

    PubMed  CAS  Google Scholar 

  21. Antons KA, Williams CD, Baker SK, Phillips PS. Clinical perspectives of statin-induced rhabdomyolysis. Am J Med. 2006;119(5):400–9.

    Article  PubMed  CAS  Google Scholar 

  22. Thompson PD, Clarkson P, Karas RH. Statin-associated myopathy. JAMA. 2003;289(13):1681–90.

    Article  PubMed  CAS  Google Scholar 

  23. Oh J, Ban MR, Miskie BA, Pollex RL, Hegele RA. Genetic determinants of statin intolerance. Lipids in Health and Disease. 2007;6:7.

    Article  PubMed  Google Scholar 

  24. Vladutiu GD, Simmons Z, Isackson PJ, et al. Genetic risk factors associated with lipid-lowering drug-induced myopathies. Muscle Nerve. 2006;34(2):153–62.

    Article  PubMed  CAS  Google Scholar 

  25. Sinzinger H, O’Grady J. Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems. Br J Clin Pharmacol. 2004;57(4):525–8.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments and Conflict of Interest

Dr Mittleman has received research funding from Pfizer; has served as a scientific consultant to Pfizer, Bayer, Lily ICOS, CV Therapeutics, AstraZeneca, and Reliant; and has coauthored peer-reviewed publications with individuals who have been employed by industry either currently or in the past. Drs. Buettner, Davis, Leveille, and Mukamal have no conflicts of interest, financial interests nor relationships or affiliations relevant to the subject matter or materials discussed in this manuscript.

No internal or external funding supported this research project.

The authors’ affiliated organizations did not participate in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Catherine Buettner MD, MPH, Roger B. Davis ScD, Suzanne G. Leveille PhD & Kenneth J. Mukamal MD, MPH, MA

  2. Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Murray A. Mittleman MD, DrPH

  3. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Roger B. Davis ScD

  4. Harvard Medical School, Boston, MA, USA

    Catherine Buettner MD, MPH, Roger B. Davis ScD, Suzanne G. Leveille PhD, Murray A. Mittleman MD, DrPH & Kenneth J. Mukamal MD, MPH, MA

  5. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Murray A. Mittleman MD, DrPH

Authors
  1. Catherine Buettner MD, MPH
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  2. Roger B. Davis ScD
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  3. Suzanne G. Leveille PhD
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  4. Murray A. Mittleman MD, DrPH
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  5. Kenneth J. Mukamal MD, MPH, MA
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Correspondence to Catherine Buettner MD, MPH.

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Buettner, C., Davis, R.B., Leveille, S.G. et al. Prevalence of Musculoskeletal Pain and Statin Use. J GEN INTERN MED 23, 1182–1186 (2008). https://doi.org/10.1007/s11606-008-0636-7

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  • DOI: https://doi.org/10.1007/s11606-008-0636-7

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