Evaluating the Jupiter Statin Study, Cholesterol and CRP

So often I ask patients to look carefully at medical research -- to look behind the headlines and evaluate the evidence. There are too many ways the results can be misinterpreted, both by patients who don't know any better, and the professionals who do know better but may choose to ignore the results in favor of making money. Happens every day.

Results for the Jupiter Study were released and have the full attention of the medical community. Based on the results, your doctor may suggest a new statin drug protocol for you to avoid heart disease or heart attacks just based on this study, even if your cholesterol numbers are in a good range.

The difference between the Jupiter Study and others is that the study group had very acceptable cholesterol numbers. Traditionally that has meant that doctors didn't think of them as being at risk for heart disease. But it turns out that half of all heart attacks happen to people who have acceptable cholesterol levels, so clearly another form of risk measurement was needed. As a result, researchers turned to a new measurement called C-reactive protein or CRP. And when they did that, they found that the risk of serious cardiac problems was cut by 44%.

As you know, I harp on transparency. Who funded the study? Who stands to make their fortune from the positive outcomes? Can we patients trust that the study was done objectively?

In the Jupiter Study, the results were so overwhelmingly positive that all parties are happy to be transparent. It was underwritten by Astra Zeneca, the company that makes the statin called Crestor, in addition to Siemens, the company that makes the test that measures CRP.

Don't get too excited, though. While many cardiologists and primary care doctors are elated at these findings, there are many who say, "not so fast!" They point to a number of factors such as the side effects, including possible damage to the liver.

Does this study apply to you? It depends on the answers to a number of questions. Here are those questions you need to discuss with your doctor:

• Did the study group reflect you? Same age, gender, cholesterol numbers, and (this is new) CRP numbers? Were enough of the people who have the same attributes as you included in the study?
• Are you already at risk for serious heart problems? Or is this CRP measurement helping to determine your risk?
• Do you have other risk factors that might suggest statins, or eliminate them as a possibility? For example, if you have diabetes, an allergy or another risk factor, it might change the conversation in either direction -- to take statins or not take them.
• If statins are indicated, are you willing to put up with the side effects? Muscle aches and pains, possible liver damage and others have been demonstrated with statins.

Additional Resources:

• Read Behind the Medical Headlines
• Crestor, from Drugs A-Z
• More about the Jupiter Study from Dr. Rich, About.com's Guide to Heart Disease
• And still more from the GoozNews (don't worry about the title -- this is a good analysis!)

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