BACKGROUND: Individuals at risk of suffering cardiovascular disease (CVD) present larger increases in blood triglyceride (TG) concentration after a high-fat meal than healthy individuals. This postprandial hypertriglyceridemia (PPTG) is an independent risk factor for CVD. Prescription of statins and a bout of prolonged exercise are both effective in lowering PPTG. We aimed to evaluate the comparative effectiveness of statins versus a bout of aerobic exercise in reducing fasting and postprandial blood TG in individuals at high risk of developing CVD. METHODS: Thirty-seven studies from a systematic literature search of the PubMed, Embase, and Cochrane databases were included in this review. The selected studies conducted trials involving statin therapy (n = 20) or a bout of aerobic exercise (n = 19) and measured their impact on PPTG as an outcome. Two studies analyzed both treatments and were included in duplicate. The meta-analysis was constructed using a random-effects model to calculate the mean difference (MD). Student's t test was used to compare the data sets for statins versus exercise. RESULTS: Overall, statin and exercise interventions showed a similar reduction in PPTG levels, with an MD of -0.65 mmol/L for statins (95% confident interval (95%CI) -0.54 to -0.77; p < 0.001) and -0.46 mmol/L for exercise (95%CI -0.21 to -0.71; p < 0.01). However, statins lowered fasting TG more than exercise (MD -1.54 mmol/L, 95%CI -2.25 to -0.83; p = 0.009). CONCLUSION: Although aerobic exercise is effective in lowering blood TG, statins seem to be more efficient, especially in the fasted state. A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD. More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.

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