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 doesn’t
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
“healthy men and women” 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 “experts” 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 don’t 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 don’t 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.
That’s 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
can’t 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 child’s
lifetime. Overweight women of child-bearing age must
make lifestyle changes to protect their future kid’s
health. You can learn more
here.
-
Parents need to teach kids from the start about
healthy foods. It’s 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 isn’t 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 doctor’s 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.