Being physically fit cuts the risk of dying by two thirds compared with couch potatoes who take statins. Pic: Jason Boud

London - Unfit people with high cholesterol levels would be better off gardening or going for a walk than taking pills, says a study.

Being physically fit cuts the risk of dying by two thirds compared with couch potatoes who take statins. Researchers found that doing more exercise could help people with high cholesterol as much, or more, than drugs.

However, it also found that combining statins with keeping fit could improve survival rates even further.

Many experts claim statins should be offered to all over-50s because everyone could benefit from lower cholesterol, but the ten-year study of 10,000 US veterans found that the very fit were 60-70 percent less likely to die than unfit people on statins.

Professor Peter Kokkinos, who led the research at the Veterans Affairs Medical Centre in Washington DC, said: “The fitness necessary to attain protection that is much the same or greater than that achieved by statin treatment in unfit individuals is moderate and feasible for many middle-aged and older adults, through moderate-intensity physical activity such as walking, gardening and gym classes.”

Kokkinos and his colleagues assessed the records of 9,700 men and 343 women from Veterans Affairs hospitals in Washington DC and Palo Alto in California. All had high cholesterol levels or other harmful blood fats and were tested to determine their exercise capacity as least, moderate, fit, or high.

The researchers found death rates were lowest among those taking statins and who were fit. The higher the level of fitness the lower the risk of dying during the median follow-up period of ten years. The fittest participants, regardless of whether they were taking statins, had a 60-70 percent lower risk of death.

The difference could not be explained by age, body mass, ethnicity, sex, history and risk factors of cardiovascular disease and medications, said the study published online in The Lancet.

Professor Kokkinos said: “Treatment with statins is important, but better fitness improves survival significantly and is a valuable additional treatment or an alternative when statins cannot be taken.”

Pedro Hallal, of the Federal University of Pelotas in Brazil, and I-Min Lee of Harvard Medical School, also writing in The Lancet, said that prescribing physical activity should be put on a par with drug prescription.

They said: “The cost of becoming physically active is lower than that of buying drugs and moderate-intensity physical activity has fewer side effects.” Side effects linked to statins include muscle pain, which can be disabling in some patients, memory loss, depression, sexual difficulties and depression.

Malcolm Kendrick, a GP, author of The Great Cholesterol Con and a sceptic of giving statins to people with a low risk of heart problems, said a recent Austrian study showed that athletes who wanted to compete could not stay on statins. “They often find they can’t take effective exercise because the statins are harming their muscles and exercise capacity,” he said.

Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: “Statins and exercise can help combat high blood cholesterol levels and look after your heart.

“However, this research shows that the two together can provide a winning combination to further improve your heart health, with higher intensity exercise possibly offering more protection.” - Daily Mail