Jumping JUPITER – Do You Know Your CRP?


One of the biggest splashes in medicine this year came when, in November 2008, the New England Journal of Medicine published the results of a study called JUPITER.

It has the whole medical world talking. This study was done to see if taking a cholesterol-lowering statin drug for primary prevention would help healthy people prevent heart attacks, strokes, heart bypass surgery, hospitalization for chest pain, and death from cardiovascular events. It did.

What is primary prevention?

Primary prevention is a term used in medicine to describe treatments that prevent conditions, diseases or injuries before they occur or cause symptoms. Healthy diet, weight management, exercise are all primary preventions.

Secondary prevention, by contrast, is a term describing treatments used to control conditions, diseases or injuries after they occur. Medications for high blood pressure or high cholesterol, diabetic diets, and cardiac rehab after bypass surgery are examples of secondary preventions.

The JUPITER study is of interest because it tested a medication that has been used as a secondary prevention as a primary prevention.

What is a CRP?

CRP stands for C-reactive protein. It is a protein in the plasma of the blood that rises in response to inflammation.

Inflammation increases the instability of plaque in blood vessels (plaque is caused by high cholesterol) and plaque that becomes unstable can rupture and cause a blockage of a blood vessel. Plaque rupture is the cause of most heart attacks and strokes.

Daily aspirin decreases inflammation in the blood vessels and so do statin drugs. And both lower CRP, too.

Elevated CRP is also a warning sign for Metabolic Syndrome. If you don’t know what that is, read this post.

About the study

The name JUPITER is short for the Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin. This was a “randomized, double-blind, placebo-controlled, multicenter trial” ). “Double blind” means neither the researchers nor the subjects knew who was getting the drug and who was getting the placebo. The study was paid for by Astra Zeneca, the drug company that makes Crestor (its generic name is rosuvastatin).

The study included 17,802 healthy people at 1315 different sites in 26 countries. All subjects had elevated levels of C-reactive protein (CRP > 2.0 – 4.2 mg/L) but normal levels of low density lipoproteins (LDL – the “bad cholesterol” = 100 – 110 mg/dL). They were randomly divided into two groups. Half were given a statin drug (Crestor/rosuvastatin at a dose of 20 mg daily) and half were given a placebo (a pill with no medicine in it).

The study was supposed to go on for 4 years but it was stopped at 2 years (1.9 years to be exact) because of the overwhelming benefit demonstrated by the statin drug in reducing heart attacks, strokes, heart bypass surgery, hospitalization for chest pain, and death from cardiovascular events.

Results of JUPITER

When the group that got the statin drug were compared with the placebo group:

  • Non-fatal heart attacks were reduced by 55%
  • Non-fatal strokes were reduced by 48%
  • Heart attacks, strokes and death combined were reduced 47%
  • LDL cholesterol (the bad cholesterol) was reduced by 50%
  • CRP (normal is less than 2.0 mg/L) was reduced by 37%

What does knowing about JUPITER mean for you?

  • Above all else, learn about and understand your own particular risk factors for disease – and that includes your CRP.
  • Know and monitor your own blood pressure, cholesterol, weight measurements (not only pounds – but BMI, waist circumference, and waist/hip ratio, too).
  • Understand how your health habits such as smoking, nutrition and exercise are mapping your health future.
  • Take your family history into account.
  • Don’t ignore problems like depression and anxiety either, because they affect your health and are risk factors, too.

The JUPITER study shows that aggressive prevention can bring dramatic results. Whether or not a statin drug is right for you is something you should discuss with your health professional. If you decide it is a good choice – remember – absolute faithfulness to taking it exactly as prescribed is the only way you will reap its benefits.

Has this post changed how you think about taking medications at all?

This information is offered for educational purposes only and is not intended to diagnose, prescribe or treat. For that please seek direct care from a health professional.

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