Harvard Women's Health Watch

Should women with normal cholesterol be taking a statin?

A major study suggests that statins also quell inflammation. Now what?

With February come thoughts of the heart, and this year you may be wondering if you should be doing more for yours. For instance, what about taking a statin, one of those medications best known for their ability to lower LDL (bad) cholesterol? Most of us with healthy LDL levels assumed we didn't need a statin to reduce our risk for cardiovascular disease. In November 2008, that assumption may have been proved wrong when a large international study — the JUPITER trial — found that the statin drug rosuvastatin (Crestor) slashed the rate of heart attacks and strokes in people with normal LDL cholesterol who had elevated levels of C-reactive protein (CRP), a marker of inflammation. There is increasing evidence that low-grade inflammation raises cardiovascular risk.

Many experts responded by recommending the prescription of statins for people whose LDL cholesterol levels would otherwise place them at low risk. Some have also urged wider use of a high-sensitivity blood test for low-grade inflammation — the hsCRP test — to identify people who might benefit. Others say those changes are not worth the cost, because people with low LDL have a very low risk of heart attack and stroke even when their blood tests show signs of inflammation. Some also think that the study, which lasted two years, was too brief to assure the safety and effectiveness of this unconventional use of statins.

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