Researchers who found that the combination of statin treatment and increased fitness boosts survival in patients with dyslipidemia are calling for the medical profession, society, and governments to make concerted efforts to promote fitness, says a Heartwire article.

Following a group of veterans with dyslipidemia for an average of 10 years, Peter F. Kokkinos, PhD, and colleagues show that both statin therapy and increased fitness lower mortality significantly and independently of other clinical characteristics.

Participants in the study were assigned to 1 of 4 fitness categories based on peak metabolic equivalents achieved during exercise testing and 8 categories based on fitness status and statin treatment. The primary end point was all-cause mortality adjusted for age, body-mass index, ethnic origin, sex, history of cardiovascular disease, cardiovascular drugs, and cardiovascular risk factors. Researchers ascertained mortality from Veterans Affairs records on December 31, 2011.

During a median follow-up of 10 years, 2,318 participants died. Mortality risk was 18.5% (935/5,046) in people taking statins vs 27.7% (1,386/4,997) in those not taking statins.

In patients who took statins, risk of death decreased as fitness increased; for highly fit individuals the hazard ratio (HR) was 0.30 compared with a HR of 1 for the least fit.

For patients not treated with statins, the HR for least fit participants was 1.35. This HR progressively decreased to 0.53 for those in the highest fitness category compared with the least-fit group treated with statins.

The study is published online in The Lancet. In an accompanying editorial, Pedro C Hallal PhD, and I-Min Lee, MD, MPH, ScD, say that Kokkinos and colleagues "add to the large body of work on the benefits of physical activity or fitness for health. Irrespective of whether patients were prescribed statins, the physically fittest participants had a 60% to 70% reduction in all-cause mortality rates during follow-up, compared with the least fit."