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11/19/08

WITH THE NEW JUPITER STATIN LOWERING HEART ATTACK STUDY SHOULD WE PUT CHOLESTEROL MEDICINE IN DRINKING WATER

WITH THE NEW JUPITER STATIN LOWERING HEART ATTACK STUDY SHOULD WE PUT CHOLESTEROL MEDICINE IN DRINKING WATER


Statins are the most powerful and popular cholesterol lowering drugs. You don't need to be Einstein to notice how much is written about them. Just search here on Purple Medical Blog or read a newspaper. The latest wrinkle in the statin story unfolded last week when a "study was released showing that the cholesterol-lowering drug rosuvastatin (Crestor) reduced heart attacks and strokes in patients without high cholesterol but with elevated high-sensitivity C-reactive protein (hsCRP) levels" C Reactive Protein is the name of a chemical in a blood test. A high CRP, (C Reactive Protein) is tied to inflammation. What does inflammation have to do with a heart attack? Having a heart attack is more complicated than just having a lot of cholesterol in the arteries (though you don't want that).

Video About Heart Attack Risk and C Reactive Protein and StatinsClick the Arrow





Inflammation is also involved with the formation of a blockage in the coronary arteries,the blood vessels that feed the heart muscle itself. The study found that the cholesterol lowering drug lowered heart attacks even in people with not so high cholesterol but who had an indication of inflammation as seen by higher CRP. So as Parker-Pope asks in the NY Times, is it time to put cholesterol-lowering statin drugs in every medicine cabinet? It depends who you ask.

"The JUPITER Study (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin) was designed to determine if treating patients with no evidence of pre-existing cardiovascular disease and low to normal LDL-C( low density lipoprotein the so called bad cholesterol) but elevated C-reactive protein (CRP) with CRESTOR 20mg once daily would reduce major cardiovascular events. CRP is a recognized marker of inflammation and is associated with an increased risk of atherosclerotic cardiovascular events".

According to the article in the Times "This (finding of the Jupiter Study) was definitely a pretty stunning result," said Dr. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. “I, for one, will be checking CRP in more patients. If it’s elevated, we will be treating them.” On the other hand "This study does not indicate that we should be putting statins in the drinking water or fortifying cereal with statins,” said Dr. Goldberg, of N.Y.U. “There are millions of people who haven’t gone in and even gotten their cholesterol checked, but everybody wants the new thing. They want to believe the new thing will be the total answer."

Video About Crestor and the Jupiter Study Click the Arrow



There have been reports before that statins may help the heart in other ways. There have even been suggestions that statins might lower the chance of Alzheimer's with the evidence going back and forth. This isn't the first battle in the war of the statins. So what to do? Well statins definitely lower cholesterol and have been shown to lower heart attacks in people with high cholesterol. But they can have nasty side effects in some people such as rhabdomyolysis, dangereous muscle breakdown that may come without warning and can lead to kidney failure. Also statins work by blocking a chemical in the liver and the liver should be monitored on a regular basis for signs of any problems.

"As a result, of this new study, some doctors say they will start testing for CRP (actually many doctors have been testing for it already but weren't sure how useful the result was) and will offer statin therapy to patients whose levels are high".

"Doctors said one worrisome trend did emerge in the study. In the statin group, 3 percent of the people developed diabetes during the study period, compared with 2.4 percent in the placebo group. Moreover, because the study was stopped early (so those in the placebo group could begin taking statins for their presumed heart benefits), it did not yield much insight into the drugs’ long-term safety. Nor is it clear that the early benefit shown in the statin group would have held up over a longer period or whether other risks might have emerged".

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