Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems.

AIMS Muscular problems are the major group of side-effects during statin treatment. They are known to occur much more frequently during and after exercise. METHODS AND RESULTS For the last 8 years we have monitored 22 professional athletes in whom, because of familial hypercholesterolaemia, treatment with different statins was attempted. Only six out of the 22 finally tolerated at least one member of this family of drugs. In three of these six the first statin prescribed allowed training performance without any limitation. Changing the drug demonstrated that only two tolerated all the four or five statins examined (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin). Cerivastatin was not among the statins prescribed. CONCLUSIONS These findings indicate that in top sports performers only about 20% tolerate statin treatment without side-effects. Clinical decision making as to lipid lowering therapy thus becomes a critical issue in this small subgroup of patients.

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