Clinical research study
Statin Use and Musculoskeletal Pain Among Adults With and Without Arthritis

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Abstract

Background

Musculoskeletal symptoms are common adverse effects of statins, yet little is known about the prevalence of musculoskeletal pain and statin use in the general population.

Methods

We conducted a cross-sectional study of the National Health and Nutrition Examination Survey 1999-2004. We estimated the prevalence of self-reported musculoskeletal pain according to statin use and calculated prevalence ratio estimates of musculoskeletal pain obtained from adjusted multiple logistic regression modeling.

Results

Among 5170 participants without arthritis, the unadjusted prevalence of musculoskeletal pain was significantly higher for statin users reporting pain in any region (23% among statin users, 95% confidence interval [CI], 19-27, compared with 18% among those not using statins, 95% CI, 17-20; P = .02) and in the lower extremities (12% among statin users, 95% CI, 8-16, compared with 8% among those not using statins, 95% CI, 7-9; P = .02). Conversely, among 3058 participants with arthritis, statin use was not associated with higher musculoskeletal pain in any region. After controlling for confounders, among those without arthritis, statin use was associated with a significantly higher prevalence of musculoskeletal pain in any region, the lower back, and the lower extremities (adjusted prevalence ratios: 1.33 [CI, 1.06-1.67]; 1.47 [CI, 1.02-2.13]; 1.59 [CI, 1.12-2.22], respectively). Among participants with arthritis, no association was observed between musculoskeletal pain and statin use on adjusted analyses.

Conclusion

In this population-based study, statin use was associated with a higher prevalence of musculoskeletal pain, particularly in the lower extremities, among individuals without arthritis. Evidence that statin use was associated with musculoskeletal pain among those with arthritis was lacking.

Section snippets

Study Population

We included 8228 adults aged 40 years or more who participated in the NHANES 1999-2004. The NHANES is a cross-sectional, continuous survey administered by the National Center for Health Statistics (NCHS).9 The survey uses a complex, multistage, probability sampling design to select participants representative of the civilian, non-institutionalized US population with oversampling of certain population subgroups to increase the reliability and precision of estimates for these groups. Public use

Results

Among 8228 NHANES participants aged 40 years or more (representing 113 million US individuals), including those with and without arthritis, 1306 participants (representing 17 million US individuals) reported using a statin in the past 30 days. Statin use increased significantly over time, with prevalence of use in the last 30 days estimated to be 13%, 15%, and 18% for study periods 1999-2000, 2001-2002, and 2003-2004, respectively (P for trend <.001).

Table 1 summarizes the characteristics of

Discussion

In this cross-sectional study of 8228 individuals representative of the general US population, we showed that use of statins is associated with musculoskeletal pain among individuals without arthritis, but that statin use does not add to the pain burden of individuals with arthritis. Among those without arthritis, statin use is significantly associated with a 33% higher prevalence of reporting musculoskeletal pain in any region after adjusting for multiple confounders (number needed to harm = 

Conclusions

In this population-based, cross-sectional study, we found that among those without arthritis, statins are associated with a higher prevalence of musculoskeletal pain, particularly in the lower extremities. These data did not demonstrate an association of a higher prevalence of musculoskeletal pain among those with arthritis.

References (24)

  • C. Buettner et al.

    Prevalence of musculoskeletal pain and statin use

    J Gen Intern Med

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  • National Health and Nutrition Examination SurveyCenters for Disease Control and Prevention

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    Funding: This study was supported by Grant K23AR055664 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

    Conflict of Interest: None.

    Authorship: All authors had access to the data and played a role in writing this manuscript.

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