The Jupiter Study: Statin Supporters are doing Cartwheels-- Are They Justified?

We are again being exposed to media reports about the ever-expanding benefits of statin drugs. These drugs are used to decrease total and LDL cholesterol levels in an attempt to prevent cardiovascular events such as heart attacks and strokes. They are already the most prescribed category of meds in the United States to the tune of more than $20 billion a year. But that doesnít stop the drug industry from trying to find new lifetime users and making billions of dollars more.

The Jupiter study presented at the American Heart Association conference and on the November 9 website  of The New England Journal of Medicine reported the results of what was to be a large 5 year study in ďhealthy men and womenĒ using Crestor. Jupiter was funded by AstraZeneca, the manufacturer of Crestor. The results were supposedly so impressive that the study was ended after less than two years. The ďexpertsĒ see this study as evidence that many more of us should be taking statins to decrease our incidence of heart attack, stroke and death due to cardiovascular disease even if we are healthy.

The Study

The randomized trial of 17,802 men over 50 and women over 60 were supposedly healthy with no history of vascular disease. However, the mean blood pressure was 134/80 (a bit high), HDL 48 (could be better), LDL 108 (good), triglycerides 118 (less than 100 is optimal), some overweight and obese subjects and 41% with metabolic syndrome. I donít call this a healthy group. Metabolic syndrome itself represents an increased risk for type 2 diabetes and its complications. You can find out if you have metabolic syndrome here.

The important marker of interest in this study was elevation of hs-CRP. All participants had an elevated level of 2mg/L or higher. This blood test measures inflammation suspected to be the real cause of atherosclerosis rather than high levels of cholesterol or LDL. Since there are a number of studies that fail to show a relationship between lowering LDL and the degree of vascular disease, inflammation is a strong suspect as to cause.

The subjects were given placebo or 20mg of Crestor for 1.9 years.

Commentary

Many people donít know, including many health care practitioners, how results in a study can be reported to make the benefits appear more impressive than they actually are.

Thatís exactly how the results of this study were presented. The media then did the rest by sensationalizing the results and quoting those who often have much to gain from the increasing use of drugs.

Yes, elevated CRP levels decreased, LDL cholesterol levels also significantly dropped in those on Crestor.

Data taken from The New England Journal editorial appearing at the same time as the Jupiter results stated that 120 subjects had to be treated for 1.9 years to prevent one event. At the cost of about $3.45 daily x 730 days x 120 people gives us an investment of about $302,000 to prevent one event. This is NOT cost-effective especially with  healthcare costs more than we can already afford.

Spending for healthcare in the US is twice that of any other country. Yet we rank 29th in infant mortality and about the same in deaths from preventable conditions. These numbers alone ought to tell us that our approach to treating sickness is not working. We canít afford more of the same by throwing expensive and potentially dangerous drugs at everyone for conditions primarily caused by lifestyle. Prevention and treatment of obesity for all ages must be a priority. How many people could have received support in making lifestyle changes for $302,000? The kind of changes that would directly address the underlying causes of cardiovascular disease. Multiply that by the millions more who are likely to be advised to take statins based on this study.

Of every 120 people treated how many will develop adverse effects by being unnecessarily treated? Adverse effects were not elucidated in the report but many stopped taking the meds. How much will treating side effects cost? Is this one reason why the study was ended so soon to avoid any negative consequences? Yet many are touting this study as evidence to expand guidelines for drug therapy. Not long ago it was recommended that some kids be given statins. There is little evidence that women benefit from statin use. This study will be used as a reason to put more women on the drugs even though the women in the study were over 60 years of age.

Among the subjects taking Crestor more developed type 2 diabetes than those in the control group. The major complication of diabetes is cardiovascular disease because of the damage insulin and high blood sugars do to the blood vessels. Is risking diabetes worth the tradeoff?

How dangerous on a long-term basis will such low levels of LDL cholesterol be? No one has a definitive answer.

How many people will continue their unhealthy lifestyles believing all they need to do is pop pills to be healthy and live longer? Too many Americans already do this.

The Real Solution

Elevated levels of CRP are commonly associated with metabolic syndrome and deposition of abnormal amounts of belly fat also known as visceral fat. This kind of fat produces a number of damaging inflammatory chemicals that can lead to vascular disease. Research has shown that losing fat when following a low carb program will normalize CRP levels. This has also been demonstrated time and again in clinical practice.

Additionally, a low carb lifestyle will improve high blood pressure, lower lipids, increase HDL cholesterol (a good thing), and change LDL particle size from small to large (also a good thing).

Controlling both the quality and quantity of carbs normalizes insulin and blood sugar levels making you less likely to develop diabetes. If you already have diabetes low carb is an effective therapy.

Above all most people living a low carb lifestyle can stop or minimize their exposure to prescription medications.

What is missing from our national dialogue about healthcare and its increasing costs overburdening our already sick economy is personal responsibility. Each of us needs to be responsible for the only body we will ever have. 

  • The environment a fetus is exposed to can influence risks of obesity and diabetes during that childís lifetime. Overweight women of child-bearing age must make lifestyle changes to protect their future kidís health. You can learn more here.
  • Parents need to teach kids from the start about healthy foods. Itís never too early to address lifelong health habits. Limit foods with added sugars and maintain a healthy weight from a young age.
  • Overweight parents must set an example for their kids. Lose that extra weight, be active and get the junk out of the house. If it isnít in the house no one can eat it.
  • Find the program that works for you and make it a lifestyle. Stop short-term dieting.

We would all be healthier and could contain health care costs if the prescription pad was the last resort rather than the first. The Jupiter study will certainly make big pharma happy but not make us healthier or better able to afford quality healthcare. 

The information presented on this site is in no way intended as medical advice or as a substitute for medical treatment. This information should be used in conjunction with the guidance and care of your physician. Consult your physician before beginning this program as you would any weight-loss or weight-maintenance program.  Those of you on diuretics or diabetes medication should proceed only under a doctorís supervision as changing your diet usually requires a change in medication dosages. As with any plan, the weight-loss phases of this program should not be used by patients on dialysis or by pregnant or nursing women. As with any weight-loss plan, we recommend anyone under the age of 18 follow the program under the guidance of their physician.