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

Erin D Michos, Roger S Blumenthal
Journal of the American College of Cardiology 2009 March 17, 53 (11): 931-5

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.

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