Statins and Musculoskeletal Conditions in US Air Force Active Duty Service Members

Background: This study examined the association of statin use and musculoskeletal conditions in statin users and nonusers within the population of U.S. Air Force active duty Service members in the military health care system. Methods: The study was a retrospective cohort analysis of Service members between 2004 and 2014 as identified from personnel data having physical fitness and cardiac risk data available and who were free of musculoskeletal diagnoses for 6 months before the study period. Based on pharmacy data, participants were divided into two groups: statin users (received a statin for at least 90 days) and nonusers (never received a statin throughout the study period). Using participants' baseline characteristics, a propensity score was generated and used to match statin users to nonusers in a 1: 3 ratio. Conditional logistic regression was used to determine the odds ratio (OR) for a musculoskeletal injury. Findings: A total of 123,138 participants met study criteria (592 statin users and 122,546 nonusers). Of these, 516 statin users were propensity score matched to 1,548 nonusers. Among matched pairs, statin users had a higher OR (OR: 1.369; 95% confidence interval [CI]: 1.166-1.606) for musculoskeletal conditions. This association was driven by a higher frequency of back problems in statin users relative to nonusers. The number needed to be exposed for one additional person to be harmed was 20.104 (95% CI: 10.326-232.711). Discussion: Statin use was associated with an increased likelihood of musculoskeletal conditions in the population of U.S. Air Force active duty Service members. Further investigations should evaluate the contribution of duty-related physical requirements as well as the duration of musculoskeletal condition-associated duty limitations.