Millions More Americans Might Be Placed on Statins

Still, "most cardiologists do not use CRP levels, because they have not been conclusively established as a reliable indicator of risk," Gardner said.

"Because of the JUPITER trial, many are considering using it in older patients," he said. But the heart association has taken no stand on the issue, he said.

A physician must consider more than CRP and LDL levels when making a decision about statin treatment, said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. High blood pressure and obesity, even at borderline levels, can tip the scale, she said.

"What we can glean from this kind of study is that patients we might consider to be at borderline risk, if they have inflammation, we should classify them at a higher risk factor status, she said. "If there is evidence of inflammation, I will start them on a statin."

One major issue noted in the analysis is that a large number of older Americans who are eligible for statin therapy on the basis of LDL cholesterol readings are not taking the medications, Spatz said.

"If we are to adopt the findings of the JUPITER trial, physicians will be challenged to reach that segment of the population that will benefit from statins," she said.

More information

There's more on CRP at the American Heart Association.

SOURCES: Erica S. Spatz, M.D., internist and fellow, Robert Wood Johnson Clinical Scholars program, Yale University, New Haven, Conn; Timothy J. Gardner, M.D., president, American Heart Association, and medical director, Center for Heart and Vascular Health, Christiana Health Care System, New Castle, Del.; Suzanne Steinbaum, M.D., director of women and heart disease, Lenox Hill Hospital, New York City; Jan. 13, 2009, Circulation: Cardiovascular Quality and Outcomes