On call: Statin therapy
Q. I am 55 years old. My cholesterol counts are normal, but my wife clipped a newspaper article about a study that found statin drugs prevent heart attacks even in people with normal cholesterol. My golfing partners all take cholesterol medication — should I join them?
A. Congratulations on being healthy, having normal cholesterol levels, and having a wife who watches over your health. Congratulations, too, on doing a little homework before you ask your doctor for a prescription.
Your newspaper was referring to the so-called JUPITER study, a multinational investigation headed by scientists at Harvard Medical School. The subjects were 17,802 apparently healthy people; nearly two-thirds were men older than 50 years of age. All the volunteers had LDL ("bad") cholesterol levels below 130 milligrams per deciliter (mg/dl), a level that is considered normal for healthy people (but high for patients with heart disease, diabetes, or high blood pressure). In addition, all the participants had elevated levels of C-reactive protein, or CRP, a marker of inflammation that suggests increased cardiovascular risk. The volunteers were randomly assigned to take either 20 mg of rosuvastatin (Crestor) or a placebo every day. The trial, which was funded by the drug's manufacturer, was scheduled to last four years but was halted after 1.9 years when a clear winner emerged. The winner was rosuvastatin, which reduced the occurrence of heart attacks, strokes, and cardiovascular deaths by 47%.