[The JUPITER trial: a new approach in primary prevention].
Current practice guidelines recommend that, when determining target LDL-cholesterol levels in individuals without cardiovascular disease and diabetes, global risk estimation be made taking into account age, sex, total cholesterol level, HDL-cholesterol level, smoking status, and systolic blood pressure. Based on this assessment, target LDL-cholesterol levels have been set as <100 mg/dL, <130 mg/dL, and <160 mg/dL for high-, intermediate-, and low-risk individuals, respectively. The most important rationale for this approach is to implement a cost-effective treatment strategy, giving special attention to high-risk individuals when allocating available sources. Recent data suggest that increased levels of high sensitive C-reactive protein (hs-CRP) are associated with increased risk for cardiovascular events, independent of other risk parameters. Most recently, the JUPITER trial demonstrated that rosuvastatin 20 mg/day significantly lowered cardiovascular mortality and all-cause mortality in low- or intermediate-risk patients whose LDL-cholesterol levels were <130 mg/dL (median 108 mg/dL) and hs-CRP levels were =/>2 mg/L. As the current guidelines do not recommend statin therapy for this patient group, these results have caused a widespread interest, giving rise to arguments about the effectiveness of primary prevention recommendations of the guidelines. This review aims to discuss the results and implications of the JUPITER trial.
Güleç
Sadi
S
Ankara Universitesi Tip Fakültesi Kardiyoloji Anabilim Dali, Ankara, Turkey. gulec99@yahoo.com
D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods / Q000639:trends; D011743:Pyrimidines / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*
D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein