Released with much fanfare in April 2009, a new study on the cholesterol-lowering statin drug Crestor made the front page of the New York Times with the headline: “Taking the statin Crestor, also known as rosuvastatin, slashed the risk of heart attack by more than half.”
The buzz: Crestor lowered the risk for heart disease by over 40 percent in people who did not have high cholesterol in the first place! The Wall Street Journal wrote: “The findings could substantially broaden the market for statins, the world’s best-selling class of medicines…”
Before you rush off to see your doctor, consider the facts. First, the JUPITER trial was funded by AstraZeneca, who make Crestor. Approximately 17,000 participants - men over 50 and women over 60 – were enrolled in the study. None had either high cholesterol levels or evidence of serious heart disease.
What they did have was higher levels of inflammation, measured in the blood as elevated C-reactive protein (CRP). The participants all had “acceptable LDL cholesterol below 130 milligrams per deciliter,” but CRP of 2 milligrams/liter or higher.
(CRP of less than 1 reflects a low risk of cardiovascular disease. Cereal Killer, Appendix A, provides a comprehensive review of all heart disease risk factors, including CRP.)
Statin drugs like Crestor inhibit the body’s production of cholesterol and may reduce inflammation. (They also deplete the body of Coenzyme Q10.) But, as you read this, keep in mind that there are many nutritious ways of reducing inflammation and none have side effects!
Eating a whole foods diet - restricting sugar and easily-digested carbohydrates – will also reduce inflammation. Avoiding highly processed vegetable oils – restaurant deep fried foods – reduces inflammation. There’s much we can do on our own to keep inflammation (actually infection) in the body low.
Point #1: You don’t have to take a drug that costs $3.50 per day and has common, serious side effects like muscle weakness and pain to keep CRP below 1 milligrams/liter.
Point #2, like most medical studies funded by drug companies, “relative risk” statistics are used to report benefits – not “absolute risk” statistics. Here’s how this works:
Reducing a disease marker from 3-in-a-million to 2-in-a-million can be reported as a 33 percent reduction in risk. The absolute or real benefit: 1 in a million!
Now it would be real hard to sell costly cholesterol-lowering statin drugs if the benefits are reported as 1 in a million, right? So what did JUPITER actually reveal:
In the non-Crestor-treated group of men and women, about 14 in 1000 developed cardiovascular disease (1.4 percent). In the treated group, 8 in 1000 developed cardiovascular disease (.8 percent). In absolute terms, 6 in a thousand may have benefitted!
How was this reported in the media: A 44 percent reduction in risk of heart disease – a headline sure to promote the sale of the drug!