"....except in sub-group of men not taking statins."

[Zee]

Finland must be a great country. Zee

Ann Intern Med 2004;140 1007-1014

http://www.annals.org/cgi/content/abstract/140/12/1007?etoc

ARTICLE Effects of Aerobic Physical Exercise on Inflammation
and Atherosclerosis in Men: The DNASCO Study A Six-Year
Randomized, Controlled Trial Rainer Rauramaa, MD, PhD; Pirjo
Halonen, MSc; Sari B. Väisänen, PhD; Timo A. Lakka, MD, PhD;
Arno Schmidt-Trucksäss, MD, PhD; Aloys Berg, MD, PhD; Ilkka
M. Penttilä, MD, PhD; Tuomo Rankinen, PhD; and Claude
Bouchard, PhD

15 June 2004 | Volume 140 Issue 12 | Pages 1007-1014

Background: Although regular physical activity is
recommended for prevention of cardiovascular diseases, no
data are available on its antiatherosclerotic effects in the
general population.

Objective: To determine whether progressive aerobic exercise
compared with usual activity slows progression of
atherosclerosis in men.

Design: A 6-year randomized, controlled trial.

Setting: Eastern Finland.

Participants: 140 middle-aged men randomly selected from the
population registry.

Intervention: Low- to moderate-intensity aerobic exercise.

Measurements: Atherosclerosis was quantitated
ultrasonographically as the mean intima–media thickness in
the carotid artery at baseline and at years 2 through 6.

Results: On the basis of intention-to-treat analyses, a
19.5% net increase (P < 0.001) in ventilatory aerobic
threshold was evident in the exercise group after 6 years.
High-sensitivity C-reactive protein levels were
statistically nonsignificantly lower in the exercise group
than in the control group (P > 0.2). The progression of
intima–media thickness in the carotid artery did not differ
between the study groups (P > 0.2). A subgroup analysis that
excluded men taking statins showed that the 6-year
progression of intima–media thickness, adjusted for smoking
and annual measures of low-density lipoprotein cholesterol
level, systolic blood pressure, and waist circumference, was
40% less in the exercise group (0.12 mm [95% CI, –0.010 to
0.26 mm]) than in the control group (0.20 mm [CI, 0.05 to
0.35 mm]).

Limitations: Only middle-aged white men were included. The
intervention included mainly aerobic exercises.

Conclusions: Aerobic physical exercise did not attenuate
progression of atherosclerosis, except in a subgroup of men
not taking statins.

more at url...

[Mirek Fidler]

> Finland must be a great country. Zee

> Conclusions: Aerobic physical exercise did not attenuate
> progression of atherosclerosis, except in a subgroup of
> men not taking statins.

Now this can be interpreted two ways

- statins had same effects as exercise
- statins prevented effects of exercise

What a pity there are not numbers from statin groups...

Mirek

[Jim Chinnis]

zwalanga@yahoo.com (Zee) wrote in part:

>Finland must be a great country. Zee
>
>Ann Intern Med 2004;140 1007-1014
>
>http://www.annals.org/cgi/content/abstract/140/12/1007?etoc
>
>ARTICLE Effects of Aerobic Physical Exercise on
>Inflammation and Atherosclerosis in Men: The DNASCO Study A
>Six-Year Randomized, Controlled Trial Rainer Rauramaa, MD,
>PhD; Pirjo Halonen, MSc; Sari B. Väisänen, PhD; Timo A.
>Lakka, MD, PhD; Arno Schmidt-Trucksäss, MD, PhD; Aloys
>Berg, MD, PhD; Ilkka M. Penttilä, MD, PhD; Tuomo Rankinen,
>PhD; and Claude Bouchard, PhD
>
>15 June 2004 | Volume 140 Issue 12 | Pages 1007-1014
>
>
>Background: Although regular physical activity is
>recommended for prevention of cardiovascular diseases, no
>data are available on its antiatherosclerotic effects in
>the general population.
>
>Objective: To determine whether progressive aerobic
>exercise compared with usual activity slows progression of
>atherosclerosis in men.
>
>Design: A 6-year randomized, controlled trial.
>
>Setting: Eastern Finland.
>
>Participants: 140 middle-aged men randomly selected from
>the population registry.
>
>Intervention: Low- to moderate-intensity aerobic exercise.
>
>Measurements: Atherosclerosis was quantitated
>ultrasonographically as the mean intima–media thickness in
>the carotid artery at baseline and at years 2 through 6.
>
>Results: On the basis of intention-to-treat analyses, a
>19.5% net increase (P < 0.001) in ventilatory aerobic
>threshold was evident in the exercise group after 6 years.
>High-sensitivity C-reactive protein levels were
>statistically nonsignificantly lower in the exercise group
>than in the control group (P > 0.2). The progression of
>intima–media thickness in the carotid artery did not differ
>between the study groups (P > 0.2). A subgroup analysis
>that excluded men taking statins showed that the 6-year
>progression of intima–media thickness, adjusted for smoking
>and annual measures of low-density lipoprotein cholesterol
>level, systolic blood pressure, and waist circumference,
>was 40% less in the exercise group (0.12 mm [95% CI, –0.010
>to 0.26 mm]) than in the control group (0.20 mm [CI, 0.05
>to 0.35 mm]).
>
>Limitations: Only middle-aged white men were included. The
>intervention included mainly aerobic exercises.
>
>Conclusions: Aerobic physical exercise did not attenuate
>progression of atherosclerosis, except in a subgroup of men
>not taking statins.
>
>
>more at url...

The sub-group analysis result did not achieve statistical
significance:

"A subgroup analysis that excluded men taking statins showed
that the 6-year progression of intima–media thickness,
adjusted for smoking and annual measures of low-density
lipoprotein cholesterol level, systolic blood pressure, and
waist circumference, was 40% less in the exercise group
(0.12 mm [95% CI, –0.010 to 0.26 mm]) than in the control
group (0.20 mm [CI, 0.05 to .35 mm])."

Note that the 95% confidence intervals overlap. The study
was too underpowered (small) to conclude anything from the
subgroup analysis. The only conclusion they can make is that
6 years of exercise did not make a statistically significant
difference in progression as measured by IMT.

The study was also not intended to separate statin users
from others. So the statistical comparison between
subgroups is a post-hoc analysis, requiring still greater
statistical power.

They should have hired a statistician before publishing.
--
Jim Chinnis Warrenton, Virginia, USA

[Zee]

"Mirek Fidler" <cxl@volny.cz> wrote in message news:<2j7lv2Ft432pU1@uni-berlin.de>...
> > Finland must be a great country. Zee
>
> > Conclusions: Aerobic physical exercise did not attenuate
> > progression of atherosclerosis, except in a subgroup of
> > men not taking statins.
>
> Now this can be interpreted two ways
>
> - statins had same effects as exercise
> - statins prevented effects of exercise
>
> What a pity there are not numbers from statin groups...
>
> Mirek

I have requested a copy of the full study. We shall see...

Zee

[James]

"Mirek Fidler" <cxl@volny.cz> wrote in message news:<2j7lv2Ft432pU1@uni-berlin.de>...
> > Finland must be a great country. Zee
>
> > Conclusions: Aerobic physical exercise did not attenuate
> > progression of atherosclerosis, except in a subgroup of
> > men not taking statins.
>
> Now this can be interpreted two ways
>
> - statins had same effects as exercise

The statements as made can not be interpreted in this way.
It clearly states that for the whole cohort exercise
provided no benefit over non exercise in terms of
inhibiting progression as measured by these authors. Yet
when the group NOT taking statins and exercising is
examined there is very strong data that exercise is heart
disease protective. No surprise at all here. This has been
known for 40 years and proven over and over. Thus it is
obvious that statins not only negate but even reverse
benfits of exercise! Otherwise the whole cohort would have
shown benfit as it would have been drug along by the
positive results of the non statin takers.

None of this should come as any particular surprise in view
of the negative effects statins have on muscles. In fact it
is very predictable. The only happy statin consumers are
couch potatoes. As we have lots of couch potatoes there are
lots of satisfied customers.

> - statins prevented effects of exercise
>
> What a pity there are not numbers from statin groups...
>
> Mirek

[Matti Narkia]

Wed, 16 Jun 2004 00:42:08 GMT in article
<6g5vc012b94namedelf2f3a2pk1fev98d2@4ax.com> Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:
>
>They should have hired a statistician before publishing.
>
They did. Pirjo Halonen, one of the authors, is a
statistician by profession, but it seems obvious that
someone else has written the conclusion of the abstract.

I wonder whether anyone would do a study relying heavily on
statistics without a professional statistician.

--
Matti Narkia

[Matti Narkia]

Wed, 16 Jun 2004 00:42:08 GMT in article
<6g5vc012b94namedelf2f3a2pk1fev98d2@4ax.com> Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

>zwalanga@yahoo.com (Zee) wrote in part:
>
[snip]
>
>>Results: On the basis of intention-to-treat analyses, a
>>19.5% net increase (P < 0.001) in ventilatory aerobic
>>threshold was evident in the exercise group after 6 years.
>>High-sensitivity C-reactive protein levels were
>>statistically nonsignificantly lower in the exercise group
>>than in the control group (P > 0.2). The progression of
>>intima–media thickness in the carotid artery did not
>>differ between the study groups (P > 0.2). A subgroup
>>analysis that excluded men taking statins showed that the
>>6-year progression of intima–media thickness, adjusted for
>>smoking and annual measures of low-density lipoprotein
>>cholesterol level, systolic blood pressure, and waist
>>circumference, was 40% less in the exercise group (0.12 mm
>>[95% CI, –0.010 to 0.26 mm]) than in the control group
>>(0.20 mm [CI, 0.05 to 0.35 mm]).
>>
>>Limitations: Only middle-aged white men were included. The
>>intervention included mainly aerobic exercises.
>>
>>Conclusions: Aerobic physical exercise did not attenuate
>>progression of atherosclerosis, except in a subgroup of
>>men not taking statins.
>>
>>
>>more at url...
>
>The sub-group analysis result did not achieve statistical
>significance:
>
>"A subgroup analysis that excluded men taking statins
>showed that the 6-year progression of intima–media
>thickness, adjusted for smoking and annual measures of low-
>density lipoprotein cholesterol level, systolic blood
>pressure, and waist circumference, was 40% less in the
>exercise group (0.12 mm [95% CI, –0.010 to 0.26 mm]) than
>in the control group (0.20 mm [CI, 0.05 to .35 mm])."
>
>Note that the 95% confidence intervals overlap. The study
>was too underpowered (small) to conclude anything from the
>subgroup analysis. The only conclusion they can make is
>that 6 years of exercise did not make a statistically
>significant difference in progression as measured by IMT.
>
After I had quickly glimpsed at the PDF-file which I
received from the Zee, it seemed that the conclusion for
the subgroup was after all statistically significant: From
the second paragraph of the right-hand-side columns of on
the page 5:

" .. A subgroup analysis that excluded 15 patients
taking statins (Figure 4, bottom) showed that the 6-year
progression of intima–media thickness was 40% less in
the exercise group (.12 mm [CI, 0.01 to 0.26 mm]) than
in the control group (.20 mm [CI, 0.05 to 0.35 mm]). The
progression leveled off in the exercise group after 3
years of intervention but continued in a linear fashion
in the control group (P = 0.02 for interaction by repeated-
measures ANOVA with covariates)."

And from the text below Figure 4 on the page 6:

"In the top panel, P = 0.2; in the bottom panel, P =
0.02 (repeated measures analysis of variance based on
intention-to- treat analysis for 140 patients with
covariates).

On the page 7 this is explicitly put in writing as follows:

"In conclusion, our data demonstrated a statistically
significant exercise-induced attenuation in the
progression of intima–media thickness in middle-aged
white men who were not taking statins. ..."

--
Matti Narkia

[Jim Chinnis]

Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in part:

>Wed, 16 Jun 2004 00:42:08 GMT in article
><6g5vc012b94namedelf2f3a2pk1fev98d2@4ax.com> Jim Chinnis
><jchinnis@SPAMalum.mit.edu> wrote:
>>
>>They should have hired a statistician before publishing.
>>
>They did. Pirjo Halonen, one of the authors, is a
>statistician by profession, but it seems obvious that
>someone else has written the conclusion of the abstract.

Yes--my comment was sarcastic, of course. The conclusion is
worded carefully to avoid actually claiming a statistically
significant result from the subgroup analysis.

I've seen instances where researchers come up with negative
results (though in this case they are interesting) and then
go astray trying to find some kind of zinger with post hoc
subgroup analyses.

>I wonder whether anyone would do a study relying heavily on
>statistics without a professional statistician.

I think they do sometimes by using cookbooks or by modeling
their study after another one that was blessed by a
statistician.
--
Jim Chinnis Warrenton, Virginia, USA

[Zee]

Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in message news:<4ic0d0d4jf9v486uig1scg0241bc7h2d47@4ax.com>...
> Wed, 16 Jun 2004 00:42:08 GMT in article
> <6g5vc012b94namedelf2f3a2pk1fev98d2@4ax.com> Jim Chinnis
> <jchinnis@SPAMalum.mit.edu> wrote:
> >
> >They should have hired a statistician before publishing.
> >
> They did. Pirjo Halonen, one of the authors, is a
> statistician by profession, but it seems obvious that
> someone else has written the conclusion of the abstract.
>
> I wonder whether anyone would do a study relying heavily
> on statistics without a professional statistician.

Matti, James, Mirek--and Bill ( who may also be interested )

I received the full study this morning and have sent it to
Jim. It seems I can't send to any of you, for various
reasons: despammed doesn't accept attachments, got a bounce
Mirek, James and Bill unreachable. I tried to be fair and
send to all. The pdf wasn't one of the 'url' kind so I
couldnt' post here. It is nine pages replete with charts and
graphs enough for all. You'll have to wait to hear from Jim

( : Zee

[Matti Narkia]

Thu, 17 Jun 2004 01:42:12 +0300 in article
<fbi1d0hdthiko5gbdcoru9gaqgq124onk6@4ax.com> Matti Narkia
<mnng1_REMOVE_THIS@despammed.com> wrote:
>>
>After I had quickly glimpsed at the PDF-file which I
>received from the Zee, it seemed that the conclusion for
>the subgroup was after all statistically significant: From
>the second paragraph of the right-hand-side columns of on
>the page 5:
>
> " .. A subgroup analysis that excluded 15 patients
> taking statins (Figure 4, bottom) showed that the 6-
> year progression of intima–media thickness was 40% less
> in the exercise group (.12 mm [CI, 0.01 to 0.26 mm])
> than in the control group (.20 mm [CI, 0.05 to 0.35
> mm]). The progression leveled off in the exercise group
> after 3 years of intervention but continued in a linear
> fashion in the control group (P = 0.02 for interaction
> by repeated-measures ANOVA with covariates)."
>
>And from the text below Figure 4 on the page 6:
>
> "In the top panel, P = 0.2; in the bottom panel, P =
> 0.02 (repeated measures analysis of variance based on
> intention-to- treat analysis for 140 patients with
> covariates).
>
>On the page 7 this is explicitly put in writing as follows:
>
> "In conclusion, our data demonstrated a statistically
> significant exercise-induced attenuation in the
> progression of intima–media thickness in middle-aged
> white men who were not taking statins. ..."
>
It all makes sense. Statins improve lipid profile and reduce
CRP. There's some evidence that exercise does the same at
least to some extent. It seems that the effects of statins
and exercise are not additive, so exercise may not bring any
further anti-atherosclerotic effect for statin users,
although others may benefit.

--
Matti Narkia

[Jim Chinnis]

Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in part:

>Thu, 17 Jun 2004 01:42:12 +0300 in article
><fbi1d0hdthiko5gbdcoru9gaqgq124onk6@4ax.com> Matti Narkia
><mnng1_REMOVE_THIS@despammed.com> wrote:
>>>
>>After I had quickly glimpsed at the PDF-file which I
>>received from the Zee, it seemed that the conclusion for
>>the subgroup was after all statistically significant: From
>>the second paragraph of the right-hand-side columns of on
>>the page 5:
>>
>> " .. A subgroup analysis that excluded 15 patients
>> taking statins (Figure 4, bottom) showed that the 6-
>> year progression of intima–media thickness was 40%
>> less in the exercise group (.12 mm [CI, 0.01 to 0.26
>> mm]) than in the control group (.20 mm [CI, 0.05 to
>> 0.35 mm]). The progression leveled off in the exercise
>> group after 3 years of intervention but continued in a
>> linear fashion in the control group (P = 0.02 for
>> interaction by repeated-measures ANOVA with
>> covariates)."
>>
>>And from the text below Figure 4 on the page 6:
>>
>> "In the top panel, P = 0.2; in the bottom panel, P =
>> 0.02 (repeated measures analysis of variance based on
>> intention-to- treat analysis for 140 patients with
>> covariates).
>>
>>On the page 7 this is explicitly put in writing as
>>follows:
>>
>> "In conclusion, our data demonstrated a statistically
>> significant exercise-induced attenuation in the
>> progression of intima–media thickness in middle-aged
>> white men who were not taking statins. ..."
>>
>It all makes sense. Statins improve lipid profile and
>reduce CRP. There's some evidence that exercise does the
>same at least to some extent. It seems that the effects of
>statins and exercise are not additive, so exercise may not
>bring any further anti-atherosclerotic effect for statin
>users, although others may benefit.

I've looked it over quickly. The basic conclusion looks
sound, that there was an exercise benefit in the non-statin
subgroup. Nothing can be said about the statin subgroup. You
have 6 subjects in the exercise group who took statins. Six.
Absolutely nothing in the statin group is statistically
significant. If one statin user went on a sausage diet in
year 4 or if one or two statin users in the control group
became marathoners,... Well, you get the idea!

A much bigger study is needed to make any comment at all on
any presumed difference in the way statin users might differ
in response to aerobic exercise.
--
Jim Chinnis Warrenton, Virginia, USA

[Matti Narkia]

Wed, 16 Jun 2004 23:40:28 GMT in article
<68m1d05mqj14tdqvv3t0l92gjgm8mas879@4ax.com> Jim Chinnis
<jchinnis@SPAMalum.mit.edu> wrote:

>Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in
>part:
>
>>Thu, 17 Jun 2004 01:42:12 +0300 in article
>><fbi1d0hdthiko5gbdcoru9gaqgq124onk6@4ax.com> Matti Narkia
>><mnng1_REMOVE_THIS@despammed.com> wrote:
>>>>
>>>After I had quickly glimpsed at the PDF-file which I
>>>received from the Zee, it seemed that the conclusion for
>>>the subgroup was after all statistically significant:
>>>From the second paragraph of the right-hand-side columns
>>>of on the page 5:
>>>
>>> " .. A subgroup analysis that excluded 15 patients
>>> taking statins (Figure 4, bottom) showed that the 6-
>>> year progression of intima–media thickness was 40%
>>> less in the exercise group (.12 mm [CI, 0.01 to 0.26
>>> mm]) than in the control group (.20 mm [CI, 0.05 to
>>> 0.35 mm]). The progression leveled off in the
>>> exercise group after 3 years of intervention but
>>> continued in a linear fashion in the control group (P
>>> = 0.02 for interaction by repeated-measures ANOVA
>>> with covariates)."
>>>
>>>And from the text below Figure 4 on the page 6:
>>>
>>> "In the top panel, P = 0.2; in the bottom panel, P =
>>> 0.02 (repeated measures analysis of variance based on
>>> intention-to- treat analysis for 140 patients with
>>> covariates).
>>>
>>>On the page 7 this is explicitly put in writing as
>>>follows:
>>>
>>> "In conclusion, our data demonstrated a statistically
>>> significant exercise-induced attenuation in the
>>> progression of intima–media thickness in middle-aged
>>> white men who were not taking statins. ..."
>>>
>>It all makes sense. Statins improve lipid profile and
>>reduce CRP. There's some evidence that exercise does the
>>same at least to some extent. It seems that the effects of
>>statins and exercise are not additive, so exercise may not
>>bring any further anti-atherosclerotic effect for statin
>>users, although others may benefit.
>
>I've looked it over quickly. The basic conclusion looks
>sound, that there was an exercise benefit in the non-
>statin subgroup. Nothing can be said about the statin
>subgroup. You have 6 subjects in the exercise group who
>took statins. Six. Absolutely nothing in the statin group
>is statistically significant. If one statin user went on
>a sausage diet in year 4 or if one or two statin users in
>the control group became marathoners,... Well, you get
>the idea!
>
>A much bigger study is needed to make any comment at all on
>any presumed difference in the way statin users might
>differ in response to aerobic exercise.
>
I agree. My general comment about exercise's effect on
lipids (at least on HDL) and CRP was based on other
available evidence, not on this study. Similarly, other
studies have shown that statins improve lipid profile and
reduce CRP. Hence my comment that the result of this study
seems to be in agreement with earlier evidence and common
sense :-).


--
Matti Narkia

[Jim Chinnis]

Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote in part:

>I've looked it over quickly. The basic conclusion looks
>sound, that there was an exercise benefit in the non-
>statin subgroup. Nothing can be said about the statin
>subgroup. You have 6 subjects in the exercise group who
>took statins. Six. Absolutely nothing in the statin group
>is statistically significant. If one statin user went on
>a sausage diet in year 4 or if one or two statin users in
>the control group became marathoners,... Well, you get
>the idea!
>
>A much bigger study is needed to make any comment at all on
>any presumed difference in the way statin users might
>differ in response to aerobic exercise.

I note that Heartwire.org has a piece on this study with a
quote from one of the investigators (Rauramaa): "Statins
have a powerful antiatherosclerotic effect and there were
more patients on statins in the reference group than in the
exercise group."

That'll explain it. Small group on statins and more of 'em
in the control arm.

Article is at http://www.theheart.org/viewArticle.do?primar-
yKey=578114&nl_id=tho18jun04
--
Jim Chinnis Warrenton, Virginia, USA

[Jim Chinnis]

Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in part:

>I agree. My general comment about exercise's effect on
>lipids (at least on HDL) and CRP was based on other
>available evidence, not on this study. Similarly, other
>studies have shown that statins improve lipid profile and
>reduce CRP. Hence my comment that the result of this study
>seems to be in agreement with earlier evidence and common
>sense :-).

Yep.
--
Jim Chinnis Warrenton, Virginia, USA

[Zee]

Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote in message news:<atm1d01mmetfcd4tfslts88gdrkshrg04l@4ax.com>...
> Wed, 16 Jun 2004 23:40:28 GMT in article
> <68m1d05mqj14tdqvv3t0l92gjgm8mas879@4ax.com> Jim Chinnis
> <jchinnis@SPAMalum.mit.edu> wrote:
>
> >Matti Narkia <mnng1_REMOVE_THIS@despammed.com> wrote
> >in part:
> >
> >>Thu, 17 Jun 2004 01:42:12 +0300 in article
> >><fbi1d0hdthiko5gbdcoru9gaqgq124onk6@4ax.com> Matti
> >>Narkia <mnng1_REMOVE_THIS@despammed.com> wrote:
> >>>>
> >>>After I had quickly glimpsed at the PDF-file which I
> >>>received from the Zee, it seemed that the conclusion
> >>>for the subgroup was after all statistically
> >>>significant: From the second paragraph of the right-hand-
> >>>side columns of on the page 5:
> >>>
> >>> " .. A subgroup analysis that excluded 15 patients
> >>> taking statins (Figure 4, bottom) showed that the
> >>> 6-year progression of intima?media thickness was
> >>> 40% less in the exercise group (.12 mm [CI, 0.01 to
> >>> 0.26 mm]) than in the control group (.20 mm [CI,
> >>> 0.05 to 0.35 mm]). The progression leveled off in
> >>> the exercise group after 3 years of intervention
> >>> but continued in a linear fashion in the control
> >>> group (P = 0.02 for interaction by repeated-
> >>> measures ANOVA with covariates)."
> >>>
> >>>And from the text below Figure 4 on the page 6:
> >>>
> >>> "In the top panel, P = 0.2; in the bottom panel, P
> >>> = 0.02 (repeated measures analysis of variance
> >>> based on intention-to- treat analysis for 140
> >>> patients with covariates).
> >>>
> >>>On the page 7 this is explicitly put in writing as
> >>>follows:
> >>>
> >>> "In conclusion, our data demonstrated a
> >>> statistically significant exercise-induced
> >>> attenuation in the progression of intima?media
> >>> thickness in middle-aged white men who were not
> >>> taking statins. ..."
> >>>
> >>It all makes sense. Statins improve lipid profile and
> >>reduce CRP. There's some evidence that exercise does the
> >>same at least to some extent. It seems that the effects
> >>of statins and exercise are not additive, so exercise
> >>may not bring any further anti-atherosclerotic effect
> >>for statin users, although others may benefit.
> >
> >I've looked it over quickly. The basic conclusion looks
> >sound, that there was an exercise benefit in the non-
> >statin subgroup. Nothing can be said about the statin
> >subgroup. You have 6 subjects in the exercise group who
> >took statins. Six. Absolutely nothing in the statin group
> >is statistically significant. If one statin user went on
> >a sausage diet in year 4 or if one or two statin users in
> >the control group became marathoners,... Well, you get
> >the idea!

Thanks gentlemen.

That'll be sausage and beer all around waiter.

Zee

> >
> >A much bigger study is needed to make any comment at all
> >on any presumed difference in the way statin users might
> >differ in response to aerobic exercise.
> >
> I agree. My general comment about exercise's effect on
> lipids (at least on HDL) and CRP was based on other
> available evidence, not on this study. Similarly, other
> studies have shown that statins improve lipid profile and
> reduce CRP. Hence my comment that the result of this study
> seems to be in agreement with earlier evidence and common
> sense :-).