CORRESPONDENCE: LETTER TO THE EDITOR
Most Would Fail to Benefit From JUPITER Intervention
William M. Plonk, Jr, MD*
* Duke University Medical Center, Medicine, Box 3003, Durham, North Carolina 27710 (Email: bill.plonk{at}duke.edu).
The recent article by Michos and Blumenthal (1) estimates that 6.5 million Americans are newly appropriate for statin therapy based on JUPITER (Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin) study data. The authors fail to recognize, however, that most of these patients will die before they are likely to benefit.
As JUPITER reported an annual control event rate of 1.36% for its primary end point, it would take 50.6 years for one-half of the study population to benefit from the intervention. From this value and published National Center for Health Statistics life expectancies, one can calculate from Table 1
the proportion likely to benefit at any given age.
Risk reduction is not beneficial if it does not prevent an adverse outcome. Subjecting aging patients to an intervention from which the overwhelming majority will not benefit is clinically inappropriate.
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References
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1. Michos ED, Blumenthal RS. 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 J Am Coll Cardiol 2009;53:931-935.[Abstract/Free Full Text]
Related Article
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Reply
- Erin D. Michos and Roger S. Blumenthal
J. Am. Coll. Cardiol. 2009 54: 744-745.
[Full Text]
[PDF]
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