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New Debate on C-Reactive Protein Test and Statins

Study Suggests CRP Blood Test May Not Predict Heart Benefits of Statin Drugs

Assessing Heart Risk continued...

The analysis raises new questions about a widely reported trial known as the JUPITER study, which prompted the FDA to broaden the uses of the statin drug Crestor, made by AstraZeneca.

The JUPITER study showed a dramatic reduction in heart attack and stroke risk in Crestor users with normal LDL and elevated CPR.

Based on this finding, the FDA last year ruled that elevated CRP could be considered a reason for the drug’s use in men aged 50 and older and women 60 and older with one additional cardiovascular risk factor, such as high blood pressure or tobacco use.

As a result, as many as 6.5 million people in the U.S. with normal cholesterol became candidates for the drug, a spokeswoman for AstraZeneca confirmed to WebMD.

In an editorial, Jean Pierre Despres, PhD, of the Quebec Heart and Lung Institute, writes that the new analysis of the Heart Protection Study data “brings more fuel to the healthy debate” about the usefulness of CRP as a predictor of heart attack and stroke risk.

Despres agrees that elevated CRP is clearly predictive of cardiovascular risk. But he says the marker of systemic inflammation is usually seen in people with another cardiovascular risk factor -- obesity.

His own research and that of others suggests a particularly strong association between elevated CRP and belly fat.

“You are not likely to see high CRP in a vegetarian monk training for the Boston Marathon,” he tells WebMD. “By far the greatest driver of elevated CRP in North America is a sedentary lifestyle and carrying too much fat around the middle.”

Because of this, he says, lifestyle modification has to be part of the discussion about how to lower cardiovascular risk.

“Statins are clearly effective, but lifestyle modification is optimal,” he says.

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