The JUPITER Study: Should everybody take Crestor?

Nonetheless, the JUPITER trial results are, admittedly, impressive. Benefits held true for both males and females. At the very least, JUPITER should put to rest some of the fringe arguments that statins do not reduce cardiovascular events. They do. There is no sense in arguing against that. While we might argue about the value of statins in various subsets of people, there is no doubt that they do indeed exert a significant effect.

However, here is my problem with the basic concept: CRP is elevated in numerous conditions (above), from simple causes like excess junk foods, to complex causes like cancer. It is especially increased when excess weight is present (and, indeed, the mean BMI in the JUPITER trial was 28─substantially overweight).

Rather than shotgun the inflammatory response with a statin drug regardless of cause, doesn't it make more sense to ask why a specific individual has an increased CRP in the first place? For instance, if the answer is vitamin D deficiency, doesn't correction of the deficiency make more sense? (Vitamin D by itself reduces CRP around 60%--more than statin drugs.) Not to mention you obtain all the extraordinary benefits of vitamin D restoration, such as reduced cancer risk, increased bone density, relief from winter "blues," rise in HDL, etc. How about junk foods, obesity, and unrelated inflammatory conditions? (Would we therefore indirectly be treating obesity with Crestor?) Surely addressing these factors are preferable to a lifelong commitment to an expensive drug with clear-cut side-effects.

In addition, Crestor 20 mg per day, in my experience and contrary to the study and to many other statin studies, will not be tolerated for long by the majority. Muscles aches are not common--they are inevitable, sometimes incapacitating. While JUPITER showed 15% of both treatment and placebo groups experienced side-effects--no different--this is wildly contrary to my experience. (And I am a consultant for complex hyperlipidemia, i.e., complex cholesterol patterns.)

So I view the JUPITER experience as yet another interesting observation made in a drug manufacturer-sponsored study, conducted by a principal investigator (Dr. Paul Ridker) who holds the patents on CRP technology. Interesting, yes. Perhaps something to bear in mind in an overall program of heart disease prevention.

But a mandate for all of us to add Crestor®? Absolutely not.