Sex Patterns of Statin Therapy and Multicomponent Exercise Training on Cardiorespiratory Fitness in Older Adults with Dyslipidemia: A 24-Month Cohort Study

Statins’ effects on cardiorespiratory fitness (CRF) and their interaction with exercise training remain unclear in older adults with dyslipidemia. This cohort study enrolled nine hundred and eighty-one older adults with dyslipidemia who underwent one of three interventions: (i) multicomponent exercise training (MEX; n = 298; 74% females), (ii) daily statin monotherapy (ST; n = 178; 65% females), or (iii) combined treatment with statins and multicomponent exercise training (STMEX; n = 505; 79% females). CRF, functional status, and lipid profile were assessed at baseline and after 24 months. After follow-up, statin therapy reduced CRF by 4% in women (p < 0.001), but not in men. The statin groups also showed reduced upper- and lower-limb strength in both sexes. Exercise alone significantly improved CRF (women: 27% vs. men: 21%, p < 0.001) and functional status, regardless of sex. The combined treatment significantly increased women’s CRF, whereas men showed an attenuated CRF benefit (women: 27% vs. men: 1%, p < 0.001). Our findings suggest sex-specific patterns in the effects of statin therapy on CRF in older adults with dyslipidemia. Statin therapy was associated with lower CRF over time in women, but not in men, whereas multicomponent exercise training may reverse these effects.