Those cholesterol numbers can be tricky, and so are the reports and advertisements you hear. The makers of statin medications want all of us to take statins, whether or not we are "sick", i.e. even if our cholesterol level is normal. This is the aim of the study called "Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin" or JUPITER study.

Now as far-fetched as this might sound, they are getting "good" cholesterol numbers to bump us into submission. And it might not be too long before you are told that you need a statin like you need vitamin in your diet. The JUPITER study reported that Rosuvastatin (or Crestor) "significantly reduced the incidence of major cardiovascular events." Aparently this refers to a 47% relative risk reduction (RRR) rate.

What These Cholesterol Numbers Mean

In presenting statistical results, advertisers will truncate graphical axes or quote the numbers that are better for sales. This is acceptable, though somewhat deceptive, so as patients (clients) we need to make sure we understand what is "behind the numbers." In the case of this JUPITER study there were 8901 subjects in the control (placebo) group and 8901 subjects in the treatment group.

From the experimental group, there were 83 events. That means 83 subjects had an incident of a heart attack or stroke during the two year period of the study. In comparison, there were 157 events in the control group.

Look at the numbers in this JUPITER study, see how these cholesterol numbers are arrived at, and then read the definitions that follow:

Control Event Rate, CER = 0.017638 (i.e. 157 divided by 8901).
Experimental Event Rate, EER = 0.009325 (i.e. 83 divided by 8901).
Absolute Risk Reduction, ARR = 0.008313 (i.e. CER - EER).
Relative Risk Reduction, RRR = 0.4713 or 47% (i.e. ARR/CER).
Number Needed to Treat, NNT = 120 (i.e. 1/ARR).

Three Significant Definitions

Absolute rate reduction (ARR) is the difference in rates of events between the control or placebo group and the treated group. The Relative risk reduction (RRR) is the extent to which a treatment reduces a risk. The Number Needed to Treat (NNT) is the number of patients who must be exposed to an intervention in order to prevent the next single occurrence of the event.

Looking at these definitions together with the calculations for the JUPITER data presented above allows you to see the results in a whole new light! Does it still look like your chance of having a heart attack or stroke if you should take Crestor would be lessened by 47 percent? Certainly not. Interpreted correctly, this is what the numbers say...

If 120 patients take Crestor at a certain dosage over a 2-year period, the drug will prevent ONE of them from having either a stroke or a heart attack. Now what's your chance? It's 0.8%. You bet, you can do better than that by eating lots more of fresh fruits and vegetables and omitting saturated fats from your diet.

Listen to the ads...

When these advertisements play on your television, you will hear loudly and clearly that Crestor decreases your risk of strokes and heart attacks (cardiovascular events) by 47 percent! Then they will muffle and speed-read some of the side effects you are likely to incur if you take the drug.

There is a big difference between what the patient hears and what the drug manufacturers and their affiliates hear. The patient hears the misleading statistical results and later discovers there are side effects that cannot be ignored. The drug makers and their affiliates hear Ka-Ching! Ka-Ching!

These results have encouraged drug manufacturers to try to sell us statins like toothpaste, whether or not we are sick! If your cholesterol level is abnormally high you have to make decisions regarding treatment choices, and there are a lot more questions you may need to ask your doctor.