Prevalence of low low-density lipoprotein cholesterol with elevated high sensitivity C-reactive protein in the U.S.: implications of the JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study.

Author(s): Michos ED, Blumenthal RS

Affiliation(s): Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA. edonnell@jhmi.edu

Publication date & source: 2009-03-17, J Am Coll Cardiol., 53(11):931-5.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVES: We assessed the prevalence of low-density lipoprotein-cholesterol (LDL-C) <130 mg/dl with elevated high-sensitivity C-reactive protein (hsCRP) in the National Health And Nutrition Examination Survey (NHANES), weighted to be representative of the general U.S. population. BACKGROUND: Rosuvastatin therapy in the JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study reduced cardiovascular events among older adults with LDL-C <130 mg/dl and hsCRP > or =2 mg/l. METHODS: Using 1999 to 2004 NHANES data, we categorized men age > or =50 years and women age > or =60 years by fasting LDL-C and hsCRP levels, excluding individuals with prevalent coronary heart disease, coronary heart disease equivalent (including diabetes), and other JUPITER exclusions. RESULTS: A total of 3.9 million men age > or =50 years and 2.6 million women age > or =60 years meeting JUPITER eligibility criteria had fasting LDL-C <130 mg/dl and hsCRP > or =2 mg/l. In addition, 6.7 million older adults with elevated hsCRP > or =2 mg/l have LDL-C levels that exceed their National Cholesterol Education Program goals. CONCLUSIONS: Extrapolating JUPITER eligibility to NHANES, an estimated 6.5 million additional adults could be potential candidates to initiate statin therapy.