94
Management
Table 24. Patients or Characteristics Associated With
Increased Risk for Statin-Attributed Muscle
Symptoms
1. Age ≥65 y
2. Low body mass index
3. Females
4. Obesity
5. Hypothyroidism
6. Diabetes
7. Chronic liver disease
8. Chronic kidney disease
9. Alcohol consumption
10. Vigorous exercise
11. High-dose statins
12. Diseases associated with myalgia or muscle weakness (eg, fibromyalgia, polymyalgia
rheumatica, polymyositis, primary myopathies)
13. Pharmacotherapy affecting statin metabolism (Section 5.2, "Statin-Cardiovascular
Drug Interactions")
14. Gene variants affecting statin metabolism (eg, SLCO1B1)
An increased risk of statin-attributed muscle symptoms is associated with the use of higher
doses of a statin within the approved dosage range. e increase in risk is not attributed to the
statin potency (higher potency statins do not have higher risk; high doses do have higher risk).
Adapted from Wiggins et al. Modified with permission from Stroes et al. Copyright © 2015
Oxford University Press. Modified with permission via Creative Commons CC BY license
from Bytyci et al. Copyright © 2022 Oxford University Press.
