Check the comment below about the JUPITER study. Note that they excluded people with high cholesterol. And yet, they had to stop the study early - because of the difference in outcomes.
The JUPITER trial enrolled healthy subjects who did not have high cholesterol levels, according to conventional benchmarks.3 The entry criterion of a low-density lipoprotein (LDL) cholesterol level of less than 130 mg per deciliter (3.4 mmol per liter) is below the currently recommended threshold for initiating pharmacologic treatment for primary prevention, although treatment at this level is indicated in patients who have clinical coronary disease or diabetes.3 In JUPITER, a high-sensitivity C-reactive protein level of 2.0 mg per liter or higher was an additional entry criterion to identify higher-risk subjects. The trial of nearly 18,000 patients was stopped, with only 1.9 of its proposed 4 years of follow-up concluded, when the data and safety monitoring board noted a significant reduction in the primary end point among participants assigned to receive rosuvastatin (142 primary events, vs. 251 in the placebo group; hazard ratio, 0.56; 95% confidence interval [CI], 0.46 to 0.69). There was a similar reduction in a combination of the more important hard outcomes: myocardial infarction, stroke, or death from cardiovascular causes (83 events in the rosuvastatin group vs. 157 in the placebo group; hazard ratio, 0.53; 95% CI, 0.40 to 0.69).
The results of JUPITER raise two important questions about the primary prevention of coronary disease. Should indications for statin treatment be expanded? And how should measurements of high-sensitivity C-reactive protein be used?
The relative risk reductions achieved with the use of statin therapy in JUPITER were clearly significant.
content.nejm.org
It could be that Crestor is more effective than the older Pravastatin? In any case, this illustrates that the entire issue is work still in progress - and always will be. For the time being, imo, a person with several risk factors should be considered for statin therapy. Below is a link to current recommendations for primary prevention from AHA:
americanheart.org |
