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Rosuvastatin to Prevent Heart Problems and Stroke in Persons 70 Years or Older FREE

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The summary below is from the full report titled “Rosuvastatin for Primary Prevention in Older Persons With Elevated C-Reactive Protein and Low to Average Low-Density Lipoprotein Cholesterol Levels: Exploratory Analysis of a Randomized Trial.” It is in the 20 April 2010 issue of Annals of Internal Medicine (volume 152, pages 488-496). The authors are R.J. Glynn, W. Koenig, B.G. Nordestgaard, J. Shepherd, and P.M Ridker.


Ann Intern Med. 2010;152(8):I-34. doi:10.7326/0003-4819-152-8-201004200-00002
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What is the problem and what is known about it so far?

Low-density lipoprotein (LDL) cholesterol is the “bad” cholesterol that increases a person's risk for cardiovascular disease (heart problems or stroke). C-reactive protein is another substance in the blood that serves as a marker for cardiovascular disease risk. Statins are drugs that lower both LDL cholesterol and C-reactive protein levels. It has been known for a long time that statins reduce cardiovascular disease in persons with high levels of LDL cholesterol. In 2008, a study showed that the statin rosuvastatin reduced cardiovascular problems in persons with no previous cardiovascular disease and normal LDL cholesterol levels but elevated levels of C-reactive protein. The results of the initial report of this study suggested that rosuvastatin benefited persons regardless of their age. However, this study included larger numbers of older persons than did many previous studies of statins and provided an opportunity to look closely at the benefits and risks of this statin in older persons.

Why did the researchers do this particular study?

To compare the safety and efficacy of rosuvastatin in older versus younger persons.

Who was studied?

17,802 persons with LDL cholesterol levels less than 130 mg/dL and C-reactive protein levels of 2.0 mg/L or more who had no previous heart problems or stroke. Of these persons, 5695 were 70 years or older.

How was the study done?

The researchers compared the rates of heart problems and stroke observed in persons older than 70 years who did and did not take rosuvastatin.

What did the researchers find?

Among persons older than 70 years, fewer heart problems and strokes occurred in those who took rosuvastatin than in those who did not. As expected, because cardiovascular disease is more common as persons age, the absolute benefit of rosuvastatin was greater in older versus younger persons. However, rosuvastatin did not result in significant changes in the overall death rates over 2 years in persons older than 70 years.

What were the limitations of the study?

The study was ended early, which limited the information on the effects of treatment beyond 2 years. No persons in the study had normal C-reactive protein levels, so this study cannot report whether the measurement of this risk factor is necessary to identify persons who might have fewer cardiovascular problems if they take rosuvastatin.

What are the implications of the study?

Rosuvastatin seems to reduce heart problems and stroke but not overall death rates in persons older than 70 years who have never had cardiovascular problems and have normal LDL cholesterol levels but have high C-reactive protein levels.

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