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Statins for Reducing CRP Levels

Statins - Not Just For Cholesterol Anymore

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Updated November 13, 2011

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We have known for years that elevated blood levels of C-reactive protein (CRP) are associated with an increased risk of heart attack and stroke. We have even known that you can reduce CRP levels with statin drugs. But until recently, we didn't know whether treating people who have high CRP levels with statins would improve their outcomes.

CRP is a marker for inflammation. Elevations in CRP levels are thought to indicate inflammation in blood vessels, a process that occurs with active atherosclerosis and increases the risk of heart attack and stroke.

The JUPITER trial, published in November 2008 in the New England Journal of Medicine, was designed to test whether statins could improve the clinical outcome of patients with high CRP levels. In JUPITER, nearly 18,000 men and women from 25 countries -- all of whom had "normal" cholesterol levels and high CRP levels -- were randomized to receive either the statin drug Crestor (rosuvastatin) or placebo.

The result? Those who were given Crestor had a 44% reduction in nonfatal heart attack or stroke, unstable angina, the need for stenting or bypass surgery, and cardiovascular death than those who were receiving placebo. Patients taking the statin also had significant reductions in both their cholesterol levels (which, again, were not elevated at the beginning of the study) and their CRP levels.

So now we know that statin therapy can significantly improve the cardiovascular outcomes of patients whose CRP levels are elevated, even when they do not have high cholesterol levels. But we still don't know whether this benefit comes from the lowering of CRP itself (or whether the CRP itself is causing cardiovascular problems, or is merely an indicator an increased risk) or from some other beneficial effect of statin drugs.

Either way, it now seems clear that statins can significantly and substantially improve the cardiovascular risk of people with high CRP levels, whether or not they also have high cholesterol.

If you are concerned about your cardiac risk, you should talk to your doctor about having your CRP levels measured. Read more here about measuring CRP levels as part of a routine cardiac risk assessment.

Read more about reducing your risk for heart disease.

Read more about statin drugs.

Sources:

Ridker PM, Danielson E, Fonseca FA et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. New Engl J Med 2008; DOI: 10.1056/NEJMoa0807646. Available at: http://www.nejm.org.

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