Exercise can be more effective at cutting deaths than statins: research Exercise should be intense enough to increasing breathing rates so participants can speak no more than three words at a time, they said. However a combination of statins and exercise was most beneficial. Professor Peter Kokkinos, of the Veterans Affairs Medical Center, Washington DC, America, said: "We don't want to give the message that is ok to throw away your statins if you take up jogging. It is best to do both. The study, published in the Lancet medical journal, found the highly fit group who were taking statins were 70 per cent less likely to die during the ten year follow up than the least fit group who were on the drugs. Between five million and seven million people in Britain take statins to lower their cholesterol levels and the drugs are known to reduce the risk of dying from a heart attack by at least a quarter. Patients taking statins tended to be sicker than those not on the drugs with that group suffering more cases of heart disease, type 2 diabetes, high blood pressure and having more smokers. They were also more likely to be on drugs other than statins for those conditions. However the results took into account age, body weight, ethnicity and other illnesses and remained similar. The analysis was based on exercise tests when participants were put on a treadmill to jog or walk on an incline until they felt they could not continue. The results were measured in METs, the metabolic equivalent of task measure, which is a way of expressing the energy expired compared to resting. Sitting or lying at rest is the equivalent of one MET. They were grouped according to fitness with those who could achieve more than 9 METs classed as the fittest and those who achieved less than 5 METs the least fit. For each one MET increase in their peak exercise capacity they could achieve, there was a 12 per cent drop in the chances of dying over the next ten years, across the whole group. For those taking statins there was a 17 per cent reduction compared with an 11 per cent reduction in those not taking statins. The researchers wrote in the Lancet: "Our findings support the notion that both statin treatment and increased fitness lower mortality significantly and independently from other clinical characteristics. For patients who cannot be prescribed statins, achieving moderate fitness (7·1-9·0 MET) offers modest protection against premature mortality. For those with an exercise capacity of more than 9 MET, protection against premature mortality is at least as much (if not greater) as that for individuals in the moderate or fit range (5·1-9·0 METs) who take statins. Thus, physical activity, which improves fitness, is an efficacious and cost-effective means to prevent premature mortality and therefore should be promoted by health-care providers. The researchers said that to achieve a peak exercise capacity of 9 METs did not require people to exercise on a weekly basis at that level, saying athletes would not train for a marathon at their race pace but at a lower speed. Prof Kokkinos said: "We are confident that accumulating 150 minutes of brisk walking or cycling per week would mean a person could score 9 METs on an exercise test." In an accompanying comment article, Pedro Hallal from the Federal University of Pelotas in Brazil and I-Min Lee from Harvard Medical School in America, said that the prescription of physical activity should be placed on a par with drug prescription. They wrote: "The cost of becoming physically active is lower than that of buying drugs and moderate intensity physical activity has fewer side-effects." Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: "Both 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. If you have high cholesterol, make sure you speak to your doctor about the best treatment regime to keep your heart healthy.