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

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.