This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Michos, E. D. Articles by Blumenthal, R. S. Search for Related Content PubMed PubMed Citation Articles by Michos, E. D. Articles by Blumenthal, R. S. Related Collections Related Article

CLINICAL RESEARCH: CRP AND CAD

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

Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland

Manuscript received October 8, 2008; revised manuscript received December 3, 2008, accepted December 8, 2008.

^_* Reprint requests and correspondence: Dr. Erin D. Michos, Division of Cardiology, Johns Hopkins School of Medicine, Carneige 568, 600 North Wolfe Street, Baltimore, Maryland 21287 (Email: edonnell{at}jhmi.edu).

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 2 mg/l.

Methods: Using 1999 to 2004 NHANES data, we categorized men age 50 years and women age 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 50 years and 2.6 million women age 60 years meeting JUPITER eligibility criteria had fasting LDL-C <130 mg/dl and hsCRP 2 mg/l. In addition, 6.7 million older adults with elevated hsCRP 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.

Key Words: JUPITER • C-reactive protein • LDL cholesterol • prevention • rosuvastatin

Abbreviations and Acronyms   ATP = Adult Treatment Panel   CHD = coronary heart disease   CVD = cardiovascular disease   FRS = Framingham Risk Score(s)   hsCRP = high-sensitivity C-reactive protein   LDL-C = low-density lipoprotein cholesterol   NCEP = National Cholesterol Education Program   NHANES = National Health And Nutrition Examination Survey

Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A28. [Full Text] [PDF]

This article has been cited by other articles:

				N. K. Choudhry, A. R. Patrick, R. J. Glynn, and J. Avorn The Cost-Effectiveness of C-Reactive Protein Testing and Rosuvastatin Treatment for Patients With Normal Cholesterol Levels J. Am. Coll. Cardiol., February 15, 2011; 57(7): 784 - 791. [Abstract] [Full Text] [PDF]

				K. K. Lee, L. E. Cipriano, D. K. Owens, A. S. Go, and M. A. Hlatky Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy Circulation, October 12, 2010; 122(15): 1478 - 1487. [Abstract] [Full Text] [PDF]

				J. Sanz, P. R. Moreno, and V. Fuster The Year in Atherothrombosis J. Am. Coll. Cardiol., April 6, 2010; 55(14): 1487 - 1498. [Full Text] [PDF]

				N. Sansanayudh, S. Wongwiwatthananukit, P. Putwai, and R. Dhumma-Upakorn Comparative Efficacy and Safety of Low-Dose Pitavastatin Versus Atorvastatin in Patients with Hypercholesterolemia Ann. Pharmacother., March 1, 2010; 44(3): 415 - 423. [Abstract] [Full Text] [PDF]

				M. A. Hlatky and P. Heidenreich The Year in Epidemiology, Health Services Research, and Outcomes Research J. Am. Coll. Cardiol., December 15, 2009; 54(25): 2343 - 2351. [Full Text] [PDF]

				E. Y. Yang, V. Nambi, Z. Tang, S. S. Virani, E. Boerwinkle, R. C. Hoogeveen, B. C. Astor, T. H. Mosley, J. Coresh, L. Chambless, et al. Clinical Implications of JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) in a U.S. Population: Insights From the ARIC (Atherosclerosis Risk in Communities) Study J. Am. Coll. Cardiol., December 15, 2009; 54(25): 2388 - 2395. [Abstract] [Full Text] [PDF]

				W. M. Plonk Jr Most Would Fail to Benefit From JUPITER Intervention J. Am. Coll. Cardiol., August 18, 2009; 54(8): 744 - 744. [Full Text] [PDF]

				E. D. Michos and R. S. Blumenthal Reply J. Am. Coll. Cardiol., August 18, 2009; 54(8): 744 - 745. [Full Text] [PDF]

				J. H. O'Keefe, M. D. Carter, and C. J. Lavie Primary and Secondary Prevention of Cardiovascular Diseases: A Practical Evidence-Based Approach Mayo Clin. Proc., August 1, 2009; 84(8): 741 - 757. [Abstract] [Full Text] [PDF]