Smoking is best known for damaging the lungs, but its effects can spread throughout the body.
People who smoke or smoked in the past may develop chronic obstructive pulmonary disease, or COPD, a long-term condition that makes breathing difficult.
Many also experience loss of muscle, which can make everyday life harder.
COPD includes lung problems such as emphysema and chronic bronchitis. Damaged airways and lung tissue make it harder to move air in and out of the lungs.
People may experience shortness of breath, coughing, tiredness and reduced ability to exercise.
Muscle health is especially important in COPD. When muscles become smaller and weaker, walking, climbing stairs and other daily activities require more effort. Muscle loss can also contribute to poor physical health and is associated with worse outcomes in people with chronic lung disease.
At the same time, many smokers and former smokers have cardiovascular disease or risk factors such as high cholesterol and diabetes. They may therefore take statins to lower cholesterol or aspirin to reduce the formation of blood clots in certain situations. Researchers have been studying whether these common medicines may also be linked with changes in muscle.
A study led by Dr. Toru Shirahata of Brigham and Women’s Hospital and Harvard Medical School examined this question in thousands of smokers and former smokers. The research was published in January 2025 in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. The team used information from the large COPDGene study.
The analysis included 4,191 participants who had chest CT scans taken at two different times. CT scans are usually used to create detailed pictures of organs such as the lungs, but they can also show muscles and other tissues. This allowed researchers to measure how participants’ chest muscles changed over time.
The team focused on the pectoralis muscles, the large muscles across the chest. Their size and appearance on CT images can provide information about overall muscle health. Comparing scans from different years allowed researchers to estimate whether muscle tissue had been preserved or lost.
An interesting pattern appeared when medication use was considered. Participants taking statins tended to show less loss of pectoralis muscle over time than people who were not using statins. This raises the possibility that statin use may be associated with better preservation of muscle in this population.
The aspirin findings pointed in the opposite direction. People who reported taking aspirin showed greater muscle loss than those who did not. Because aspirin is commonly used by people with cardiovascular disease, the result could be important if it is confirmed by further studies.
However, the study does not prove that statins protect muscles or that aspirin damages them. Participants were not randomly assigned to take these medicines, so people using aspirin or statins may have differed from nonusers in important ways. Their age, heart health, diabetes, physical activity or other medical conditions could partly explain the associations.
This issue is particularly important for aspirin because people who take it may already have more cardiovascular disease. Poorer overall health could itself contribute to muscle loss. Researchers therefore need controlled studies and additional analyses before deciding whether the medicine has a direct effect on muscle tissue.
Statins also have a complicated relationship with muscles. Although the new study found an association with less muscle loss, statins are known to cause muscle aches or weakness in some patients. The findings should therefore not be interpreted as a reason to begin taking a statin specifically to preserve muscle.
Likewise, people taking aspirin for a medical reason should not stop because of this study. Aspirin can be important for preventing another heart attack or stroke in selected patients, and suddenly changing treatment could create serious risks. Medication decisions should be made with a doctor who can consider the person’s full medical history.
The study’s large number of participants and use of repeated CT scans are important strengths. Instead of relying only on people’s reports of strength or body weight, researchers could directly examine changes in chest muscle over time. Still, the observational design means that cause and effect remain uncertain.
The research also highlights a broader issue in COPD care. Protecting lung function is important, but maintaining the rest of the body matters too. Physical activity, pulmonary rehabilitation and adequate nutrition can help people with COPD preserve strength and remain more independent.
Overall, the findings open an interesting new area of research into how common cardiovascular medicines may relate to muscle health in smokers and former smokers.
Statin use was associated with less chest muscle loss, while aspirin use was associated with more, but neither relationship has yet been proven to be caused by the drugs themselves. Further studies are needed before these results should change medical treatment.
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