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Effect of Statins on Skeletal Muscle Function
Open accessAbstract
Background—: Many clinicians believe that statins cause muscle pain, but this has not been observed in clinical trials, and the effect of statins on muscle performance has not been carefully studied. Methods and Results—: The Effect of Statins on Skeletal Muscle Function and Performance (STOMP) study assessed symptoms and measured creatine kinase, exercise capacity, and muscle strength before and after atorvastatin 80 mg or placebo was administered for 6 months to 420 healthy, statin-naive subjects. No individual creatine kinase value exceeded 10 times normal, but average creatine kinase increased 20.8±141.1 U/L ( P <0.0001) with atorvastatin. There were no significant changes in several measures of muscle strength or exercise capacity with atorvastatin, but more atorvastatin than placebo subjects developed myalgia (19 versus 10; P =0.05). Myalgic subjects on atorvastatin or placebo had decreased muscle strength in 5 of 14 and 4 of 14 variables, respectively ( P =0.69). Conclusions—: These results indicate that high-dose atorvastatin for 6 months does not decrease average muscle strength or exercise performance in healthy, previously untreated subjects. Nevertheless, this blinded, controlled trial confirms the undocumented impression that statins increase muscle complaints. Atorvastatin also increased average creatine kinase, suggesting that statins produce mild muscle injury even among asymptomatic subjects. This increase in creatine kinase should prompt studies examining the effects of more prolonged, high-dose statin treatment on muscular performance. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00609063.
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In the citing paper
“Among the 420 statin-naïve subjects randomized to atorvastatin 80 mg daily or placebo for 6 months, 9.4% of the statin-treated and 4.6% of control subjects met the study definition of myalgia (P = 0.054)”
In the citing paper
“The STOMP study also found no differences in the measures of muscle strength or exercise performance between statin-treated and placebo subjects.”
In the citing paper
“The Effects of Statins on Muscle Performance (STOMP) study is, to our knowledge, the only randomized, double-blind, placebo-controlled study specifically designed to examine the effect of statins on skeletal muscle symptoms and performance.22”
In the citing paper
“suggesting that the incidence of muscle complaints due to the statin is considerably less than that reported in observational trials.”
In the citing paper
“Discomfort and weakness typically occur early (within 4–6 weeks after starting statin therapy22), but may still occur after many years of treatment.”
In the citing paper
“One study, designed specifically to study the effects of statins on muscle symptoms, suggests that the frequency of muscle-related complaints is ≏ 5%. 217”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [217]
In the citing paper
“Medications such as statins may provoke symptoms such as muscle pain or weakness, which can be confused with normal post-exercise soreness, especially in individuals not accustomed to PRT [[588], [589], [590]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [588]
In the citing paper
“Medications such as statins may provoke symptoms such as muscle pain or weakness, which can be confused with normal post-exercise soreness, especially in individuals not accustomed to PRT [[588], [589], [590]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [588]
In the citing paper
“One study, designed specifically to study the effects of statins on muscle symptoms, suggests that the frequency of muscle-related complaints is ~5%.217”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [217]
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Citations
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Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000625 · Cited by 6,185
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Interpretation of the evidence for the efficacy and safety of statin therapy
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Metadata
- Authors
- Parker, B. A., Capizzi, J. A., Grimaldi, A. S., Clarkson, P. M., Cole, S. M., Keadle, J., Chipkin, S., Pescatello, L. S., Simpson, K., White, C. M., & Thompson, P. D.
- Affiliations
- Hartford Hospital (US)
- Venue
- Circulation
- Published
- 2013-01
- Volume
- 127
- Issue
- 1
- Pages
- 96-103
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4450764
- OpenAlex
- W1982914740
- Cited by
- 500
- References
- 27
- Citations by year
- 2026: 14 · 2025: 28 · 2024: 30 · 2023: 25 · 2022: 43 · 2021: 39 · 2020: 37 · 2019: 39 · 2018: 42 · 2017: 41 · 2016: 57 · 2015: 52 · 2014: 33 · 2013: 17
- FWCI
- 33.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL081893)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- statins, atorvastatin, skeletal muscle function, muscle strength, exercise capacity, creatine kinase, myalgia, statin-induced myopathy, high-intensity statin therapy, healthy volunteers
- MeSH terms
- Atorvastatin, Adult, Creatine Kinase, Double-Blind Method, Exercise Test, Female, Heptanoic Acids, Humans, Male, Middle Aged, Placebos, Pyrroles, Exercise Tolerance, Muscle, Skeletal, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Muscle Strength, Young Adult, Musculoskeletal Pain
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