In Healthy Statin Recipients, Low HDL Might Not Confer Risk After All

In primary and secondary prevention trials, statins have significantly lowered risk for adverse cardiovascular events and death — but some risk always remains. After LDL cholesterol levels have been reduced substantially by statin therapy, how much of the remaining vascular risk can be explained by continuing low levels of HDL cholesterol?

In the industry-sponsored JUPITER trial (JW Gen Med Nov 18 2008), 17,802 patients with baseline LDL cholesterol levels <130 mg/dL, high-sensitivity C-reactive protein levels ≥2 mg/L, and no history of diabetes or cardiovascular disease were randomized to daily rosuvastatin (20 mg) or placebo. After a median 2 years of follow-up, the rosuvastatin group had reached a median LDL cholesterol level of 54 mg/dL …