Crestor: To Take or Not To Take

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When drug research like the recent Crestor study makes headlines in the Chicago Sun-Times and the national media, I know I’ll be fielding questions from patients. The very day after the Crestor study, in fact, the perky Crestor drug reps arrived in my office, barely able to contain their glee about the study’s conclusions. I was pretty sure their unmitigated joy was vastly surpassed by that of their company’s CEO, whose dollar-sign eyeballs were surely glowing somewhere in a darkened Crestor boardroom.

So what’s all the fuss about? We discussed statins in an earlier health tip, but in case you missed it, I’ll review. Crestor is the newest of the statin drugs. Everybody knew it would lower cholesterol, but lowering cholesterol per se doesn’t seem to prevent heart disease. Stuck with a cholesterol-lowering product just when it’s becoming passé to lower cholesterol, researchers were curious about what would happen if they gave it to people with completely normal cholesterol levels. So they did.

Dividing several thousand patients regardless of cholesterol, high or low, into two groups, they gave one group a standard 10-mg dose of Crestor and the other a placebo. After a couple of years, they found that Crestor, even when taken by someone with a perfectly normal or even low cholesterol, reduced heart attack risk. (Everything has a price: there was a slight increase in cancer among the Crestor users, possibly because statin drugs block your body from making the antioxidant Coenzyme Q 10).

Crestor worked not by lowering cholesterol, but by reducing inflammation. It’s the inflammation inside your arteries that predisposes your cholesterol (no matter how low) to deposit itself as artery-blocking plaque. To measure inflammation in the test subjects, researchers measured blood levels of an inflammatory marker called C-reactive protein (CRP) and indeed Crestor did lower it.

This news came out the same week that extensive research poo-poo’d the heart-protecting effects of vitamins C and E. With this study result, Crestor is now poised to become “the new and really effective Vitamin C.” I can see their next ad: “Toss your Vitamin C and start taking Crestor.” (Don’t do it. Vitamin C is good for a lot of other stuff in your body.)

So, you sensibly ask, should everyone be taking Crestor? For a straight answer, it’s probably best not to look to our starry-eyed Crestor rep. Personally, with a normal cholesterol level, I certainly wouldn’t. Here are several reasons why:

• Statins are not the safest drugs on the planet. They cause a variety of side effects, including alteration of liver enzymes, muscle cramps, digestive problems, and change in mental functioning.

• You may not have a problem with inflammation. To check inflammation, you can ask your doctor for a hs-CRP (high sensitivity-CRP) test. The test costs about $50, but be aware many insurance companies won’t pay for it. Some of your inflammatory risk is genetic, some lifestyle-driven. Dr Andrew Weil describes a healthy low inflammation diet here. The diet itself is quite tasty, but you’ll need to abandon your cigarettes, Little Debbies, and corn dogs, all inflammation boosters.

• Keep in mind that the Crestor study went head-to-head against a placebo. Plain old penny-per-tablet aspirin, a proven preventer of heart disease, is also an anti-inflammatory. Just take the heart-protecting dose of 81 mg a day. If you’re sensitive to aspirin or simply prefer a non-drug solution, my personal favorite anti-inflammatory is the spice turmeric, available as Circumin Plus in a convenient once-a-day capsule here. You can also add turmeric to many foods. Try it in scrambled eggs or sprinkled on pizza.

Meantime, don’t hold your breath waiting for a Crestor-vs-aspirin or Crestor-vs-turmeric study to headline any time soon. These studies are generally funded by drug companies and they’ll never pay for a study in which their product might be proved inferior to a kitchen spice.