JUPITER Study Changes Doctors' Approach to Heart Disease Prevention - The key: your CRP
The JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study has shown that statins prevent heart disease and lower risks of stroke and death – even in individuals with normal cholesterol levels.
The key: your CRP
JUPITER enrolled more than 17,000 otherwise healthy participants with normal levels of LDL (the “lethal” cholesterol), but elevated levels of “high-sensitivity C-reactive protein” or CRP.
CRP, a measure of inflammation in the body, is linked to heart disease and other illnesses. Statins primarily lower LDL and raise “healthy” HDL cholesterol levels, but they also reduce CRP levels.
Half the study participants received the common statin medication rosuvastatin. The other half received an inactive “placebo” pill. Investigators tracked the incidence of heart attack, stroke and hospitalization or death from cardiovascular causes; because it was so much lower in the statin group, they halted JUPITER early.
Even if your health is good and your cholesterol in normal, it’s important to know your CRP levels. These can be determined through a simple blood test ordered by your doctor. Your doctor will alert you if your CRP levels are high and advise you on whether require statin therapy.
Lifestyle change too
Although everyone in the JUPITER trial received dietary counseling, the trial showed only those taking statins had about a 50 percent reduction in risk. Dr. Leslie Cho, Director of the Cleveland Clinic’s Women’s Cardiovascular Center and Section Head, Preventive Cardiology and Rehabilitation, states, “Drugs are a supplement, not a substitute, for a healthy lifestyle. Losing weight helps reduce CRP. Exercise can lower CRP. Smoking increases CRP.
Are all statins the same?
The response to statin therapy is very patient specific. Patients react to medications differently. Other statins have been shown to lower CRP as well. However, JUPITER used only one type of statin at a specific does – thus, it is unknown whether other doses of statins would achieve the same response. The best thing to do is work with your physician to meet the goal of lowering LDL and CRP to achieve optimal levels in a way that is best tolerated by the patient.
The final message
The Preventive Cardiology and Rehabilitation Center team has used CRP for a long time to help determine who requires more aggressive cholesterol control. The JUPITER study confirms this.
Dr. Cho states, “Get your cholesterol checked, know your risk factors and try to modify them. This is a great study to bring out the importance of CRP. Get your CRP checked. The message is: become proactive. Bring it up with your doctor. Get your questions addressed."
> Learn more: What is High Sensitivity C-reactive Protein?
Reviewed by Dr. Leslie Cho, Director of the Cleveland Clinic’s Women’s Cardiovascular Center and Section Head, Preventive Cardiology and Rehabilitation at the Miller Family Heart & Vascular Institute at Cleveland Clinic.
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