Managing Your CV Inflammation:The JUPITER TRIAL & Statins

[@bobcocampo]

What was suspicious in other video is the raw data on why the study was stopped In less than 2 years. What was the reason for stopping the trial if it is doing good? What dose was given in the trial?

[@PrevMedHealth]

They stop trials when something is working so well because they don't think they will learn more by completing it. Meanwhile it allows a head start for patients to benefit from the new therapy.

[@thibaudjacquemaire7076]

But was LPa considered in the study?

[@willbrink]

@@thibaudjacquemaire7076 Statins can raise LPa, yet reduce CVD and MI, so the effects on LDL-C/ApoB and CRP clearly a net benefit effect.

[@bartrobinson2103]

Another excellent video! I'm the perfect example of a veryfit 59 year old who's always had great standard blood work results but a very high calcium score of 500 three years ago. My doctor recently had no problem switching me to 10 mg. daily rousuvastin. When I hopefully convince him to do a complete inflammation panel I'll ask him to reduce dosage as per your suggestion if numbers are good. But I'm not sure he'll want to do that. No side effects so far after 3 months that I know of. Learning from you everyday Doc!!

[@ellfra2]

Get on K2 and Keto, all the same benefits with none of the downsides of statins.

[@BruceCartland-iu3jl]

Dr Paul Mason's review 'The truth about Statins' (1 year ago) at 10 min mark, comments briefly on the Jupiter trial in very unflattering terms.

[@delbertshankle8992]

Crestor 10mg daily upped my blood glucose from 106 daily to 135/145 daily and 20lbs in weight LDL 70 HDL 36 Trig 88, 4 stents August 21

[@milanpintar]

In the case of the JUPITER trial, the results showed that rosuvastatin was highly effective in reducing the risk of cardiovascular events and death, and the trial steering committee and independent data and safety monitoring board deemed it unethical to continue giving placebo to the control group.

[@Gigi-z3z]

I am extra, extra grateful that you switched me to Rosuvastatin. I'm also extra grateful to the Jupiter study! However, the study makes it especially perplexing to see that most doctors still prescribe Lipitor or other statins even when people have had cardiovascular events and blockages. I look forward to you addressing this phenomenon on a later video.

[@PrevMedHealth]

Thanks, Gigi.

[@6789uiop]

"perplexing" You're so kind Gigi... lol.

[@wcbibb]

Systemic inflammation, especially Interleukin-17, is involved in coronary artery disease. Use of biologic therapies in psoriasis patients resulted in a significant regression of non-calcified plaque burden as measured by computerized coronary tomographic angiography ("CCTA"), according to Youssef A. Elnabawi, et al. In Cardiovascular Research, 05 February 2019. Inflammatory conditions greatly increase cardiovascular risks. Inflammation has joined family history, hypertension, obesity, diabetes, type 2, etc. as a significant risk factor. I researched gout and coronary artery disease and likewise found a strong association with coronary artery disease. It is the soft, "hot" plaque inside the walls of the coronary arteries that is the dangerous component. The soft plaque ruptures and thrombus embolizes. Biologics can reverse the soft plaque burden.

[@vincentnonnenmacher9352]

Do you have study on that available for public access. I’m desperately trying to involve my MD and my cardiologist to look at cause of my gout and link it to HBP and an MI I endured 3 years ago, but never have them consider there is a causation link between them. Seems like those are too much doctors specialty and they don.t look at a broader picture level. It’s hard for patients, as they rapidly biased on their own 1:1 confirmation bias, without any clue on the science or disensus between researchers.

[@wcbibb]

@@vincentnonnenmacher9352 Gout increases your risk for heart disease. Tiny particles of uric acid cause inflammation, such as in your big toe. Whether this is a "cause" in theory seems to be straightforward. Go to www.pubmed.com and enter "gout" and "heart disease". I believe in the inflammatory theory of heart disease. Small particles of LDL require stress to pack them into the middle layer of the coronary artery plus the inflammatory response of the body. Particle disease is the bodies response to the tiny crystals of uric acid.

[@wcbibb]

@@spacejaime Biologic therapies involve the use of living organisms or laboratory-produced versions of such substances to treat disease. Immunotherapy (indirect) targets certain antibodies rather than targeting cancer cells directly (direct) In psoriasis, biologics act as a brake on the immune system. There are immune checkpoint proteins on the surface of T-cells. Cytokines are chemical messengers. Interleukins are messenger molecules between immune cells. The biologic is a medicine that can target an overactive immune system or a component thereof. The biologic can target a specific part of the immune system such as T-cells or TNF-alpha (tumor necrosis factor). In the case of psoriasis, the biologic targets the activity of interleukin-23 to modulate it down to reduce inflammation. Reducing inflammation seems to also reduce inflammation in the coronary arteries. That reduces heart attacks incidentally, according to the study and anecdotal observations by doctors over the years. As a disclaimer, I am a lawyer, not a physician.

[@jaimeballester840]

William, thanks for the reply. BTW, doctors and lawyers are much needed professionals for us laymen. Dr. Brewer covered ( several times and in detail) the gooey hot spots as the real culprit of cardiac infarctions. Thanks!

[@wcbibb]

@@jaimeballester840 Lawyers get heart attacks, strokes, and cancer, too. A few of us have gout. lol

[@davidivers9295]

My Doc has me on 40mg of Crestor and I believe it's raising my A1c. Will check it again soon. He's totally focused on ksl, wants me to do the injectables. Will see if my GP will write a lower dose, something closer to 5mg. Ps Very good interview on today's Mercola newsletter with Dr. Benjamin Bickman, research Doc at BYU. Connecting more dots. Worth a look.

[@willbrink]

The issue is the "normal" is too high, and based on population data. So, those with "normal" cholesterol having MI events are still too high. What's most predictive is apoB apparently. Having said that, those who continue to ignore inflammation as a key risk factor, are doing it wrong and costing lives. Both need to be tracked/tested and mitigated as needed.

[@andybowman9697]

So many demonize statins saying LDL is not what causes heart disease. While that may be at least partially true, there are other benefits like plaque stabilization for starters..

[@rone6345]

I love Dr Brewer's work and channel, but I really find the Jupiter study unconvincing. We're talking about a 1% risk reduction (but the marketers lie to the public and say 36% reduction). If we consider the countless variables which were not controlled for I can't help but think this is statistically insignificant. I think the benefits are offset by the adverse effects. Based on the weight of evidence and studies I'm much more inclined to be in the Dr David Diamond/Cummings (would love to get your opinion on the studies/data they use) camp on LDL and statins after listening to both sides debate this tirelessly. Control your blood sugar, fast, don't overeat, use metformin, etc., but I don't see the great benefits that statins are purported to have.

[@PrevMedHealth]

Thanks. I understand. It just happens that I ‘ve done that exact video. kzbin.info/www/bejne/oKnCoJmtiqyobtk

[@rone6345]

@@PrevMedHealth Thanks Doctor, I watched the video. I completely understand your clinical decisions and the many nuances involved that us laymen do not have to consider. As always your open mindedness and thorough review of the research is greatly appreciated!

[@PrevMedHealth]

Rone Thank you so much!

[@geoffreystone4849]

Would you support HOMA-IR determination for pre diabetic indication?

[@larisamukhomorova8371]

There is much more to CRP topic than what JUPITER was focused on. It's not a CRP study, it's a rosuvastatin study. And it's not a cholesterol either which causes atherosclerosis. And JUPITER study, by the way, indirectly points at that as cholesterol levels in study subjects were not elevated.

[@brianpattison4417]

Thoughts on the 2010 re-appraisal published in the Archives of Internal Medicine. That probably explains why most doctors don't shout from the rooftops about The Jupiter Trial.

[@steelhorses2004]

I've tried most of the most popular statins - lipator, zocor, crestor and now livalo. Each one caused me muscle ache and sharp pains and also caused mental "fogginess". I tolerate Livalo the best but it still causes me some level of brain fogginess. I know this because I went thru a bout of samonella and stopped taking all my meds for 5 days and after about 3 days I was much sharper mentally. Once I went back on the meds after a couple of days I felt less sharp mentally, having to focus more and my memory suffered somewhat. It's a catch 22 - statins do so good for my heart but affect my mental abilities.

[@PrevMedHealth]

Thanks for sharing that.

[@tomd790]

People who can't tolerate a statin can often take niacin which will help to a degree on lipids but not much on inflammation.

[@PrevMedHealth]

Yes. Thanks.

[@jonnyde]

Some very interesting information to consider ... especially at 11:09 I didnt hear any anything about the 'Death from all Causes' graph where the placebo and statin have almost the same curve. The way I see the data as shown here is that statin have both positive and negative health benefits on a 10,000+ random sample(?): perhaps one less death in that number of patients overall? From another slide that was not discussed it looks like there are kidney issues. Just my Canadian nickels worth (since we dont have pennies anymore)

[@gregdiamond4328]

Excellent information 👍 I'm still on atorvastatin 40mg. I recently had a CT scan (7-8 mm kidney stone) indicating degenerative disc disease at multiple levels in the lumbar spine. I have had back pain since I was 8yrs old I'm now 68. So if Atorvastatin causes back pain I would not know, lol. Thanks again for all the excellent videos.

[@6789uiop]

Rosuvastatin may be worth another look for me because my hsCRP went up to 3.3 last year. But I've been eating more carbs, and even sugar since the beer virus. I always have to request CRP tests or it's not included.

[@JJY888]

My doc prescribed me 20 milligrams of Crestor with a total cholesterol of 240? I'm taking it every 3rd day.

[@annettefowler4704]

THANK YOU

[@RafaelViaud]

Look for the investigation report: "Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin-JUPITER Controversy A Critical Reappraisal". Their conclusion: "The results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors."

[@stu42000]

What do we know about the diets of the subjects involved in this study? In this study, in all cases, HDL did not increase, TG decreased from 118 to 99 for those treated with the statin, but the ratio TG/HDL remained greater than 2. You and others have said that the TG/HDL ratio is very important. My TG/HDL dropped to below 2 six months after adopting a low carb high fat diet combined with intermittent 18-6 fasting and stayed there after dropping rosuvastatin. My ratio on rosuvastatin and diabetes meds was well above 2 and the A1C when I first started the diet was 9.5. Is there a study that takes diet into account?

[@PrevMedHealth]

Great points about diet. It’s more important. But no, all these studies assumed a random dietary impact.

[@rajeevarora190]

Dr. Brewer - thanks for all the nice videos. Is it there any benefit in taking a statin with LDL below 60 mg/dL and hsCRP less than 0.40 mg/L.

[@SawmillerSmith]

From the study it looks like they did not say if those people in the study eat a healthy diet from what I can tell. My guess is they are lots of carbs and sugar .

[@victordasilva5255]

What about omega 7 supplements that reduce C-reactive protein by over 40 percent. (Says a Cleveland clinic cardiologist )

[@thibaudjacquemaire7076]

Thanks for the videos!! What about LPa influence in the Jupiter study? Was that considered? Thanks again for all!

[@PrevMedHealth]

You're Very Welcome! Join Our Live Broadcast Every Wednesday! @11am EST. For more information please visit our website prevmedhealth.com/ & www.jubilee.health/. To learn more watch our videos on KZbin kzbin.info/door/moEsq6a6ePXxgZeA4CVrUw

[@kellyclover5953]

What would you do with a patient who had 0.7 for Hs CRP but 152 for Lp PLA2 activity and high triglycerides? Would you still prescribe the statin?

[@Tmanaz480]

Would this apply to atorvastatin as well?

[@drlouiscardinal752]

Excellent video as always, but I don’t accept the data on side effects of statins. I tried three different statins got extremely sick on all of them after about three weeks and felt 100% better two to three days after going off. I did not need to try a fourth. I meet too many people that have been affected in a similar fashion. But I like the idea of taking a statin at a much lower dose for its anti-inflammation properties. Perhaps at those low doses there would be no side effects. But my C- reactive protein is normal so not going there for now. Keep up the good work doctor your videos are awesome.

[@redberries8039]

..well ...the vid has gone a long way to changing my mind about statins ...

[@TheJTMarlin77]

I would research way more than one YT video to determine whether statins are good or not

[@PrevMedHealth]

Thanks. Glad to hear it.

[@GodzillaGoesGaga]

This is a cited research study and is as good as going on pubmed or government websites. The JUPITER study is one of the better studies.

[@jimbo7577]

Doctor, I remember reading an article about C reactive protein and it mentioned that aspirin and vitamin C among other things would also lower inflammation and C reactive protein. Could you make a video on ways to lower inflammation using natural supplements?

[@PrevMedHealth]

We have discussed Niacin, CoQ10, dark chocolate, garlic, etc. As with all drugs & supplements- some things are clear. And some aren’t. And neither are a replacement for proper weight, diet, exercise, sleep, stress management, etc.

[@jimbo7577]

@@PrevMedHealth Thank you sir, I appreciate the reply

[@T-Slider]

Very interesting. I stopped taking crestor last Aug. muscle pain. I had been on every statin starting with mevecor since 1988. They all start out ok, and then at some point start causing pain. I was on Crestor last. I’m now on Repatha. It lowers cholesterol, but what is known about its effects on inflammation?

[@Gigi-z3z]

Joe A7Rii Were you also taking a COQ10 Ubiquionone/Ubiquinol supplement as an adjunct to the statins? This can be very beneficial. Best wishes~~

[@tomd790]

PCSK9 inhibitors don't generally decrease inflammation as well as a statin.

[@PrevMedHealth]

Thanks, Tom. I have been meaning to check citations on that. Do you have any?

[@bartrobinson2103]

Can anyone recommend any companies other than cardio risk for a cimt in Delaware, Southern New Jersey or Philadelphia area that are reputable? Cardio Risk people are not within 2 hours from where I live. Any replies much appreciated!

[@jtclaf]

Yes it would be very much appreciated, thanks

[@redberries8039]

So statins are preferable to the niacin if well tolerated?

[@tomd790]

Absolutely, not even close. However, niacin does have its advantages for some health issues.

[@Allessio777]

2 mg Livalo was the 1st statin that did not cause me overt muscle pain. Crestor, Lipitor, and Zocor all caused pain and I had to diminish and/or quit. It is expensive and I get it from a Canadian Pharmacy. Is there a Livalo video on this channel Dr Brewer?

[@thibaudjacquemaire7076]

Same here.

[@Bpjames]

In defense of David Diamond, his argument about the efficacy of statins, besides being very low, was that they were using a 1% actual statistical benefit and using relative risk calculation to make it a 37% benefit for their advertising. The legal loophole thing really got my attention, but I am still open minded enough to pursue any and all knowledge on statins. Thanks for all your uploads Dr Brewer.

[@DanielTrevorOnline]

I agree - please see my post above about David Diamond's analyses. Daniel

[@anniekate1914]

Please i dont see your post above about David Diamond

[@Bpjames]

@@DanielTrevorOnline Please repost your thoughts on David Diamond, I would be interested to see.

[@DanielTrevorOnline]

@@Bpjames and anniekate1914 - on my end I am seeing my post as the very first Comment at the top. Let me know if you still can't see it and I will repost it here. Thanks. Daniel

[@DanielTrevorOnline]

@@anniekate1914 on my end I am seeing my post as the very first Comment at the top. Let me know if you still can't see it and I will repost it here. Thanks. Daniel

[@nbfazel]

Thank you, Doctor. What about folks who have low cholesterol levels AND low inflammation (e.g. high sensitivity CRP is 0.6) but have coronary artery calcification? Do they still benefit from taking statins?

[@PrevMedHealth]

You left out the biggest question. Do they have plaque? If so, I’d recommend a statin. If not, I wouldn’t.

[@nbfazel]

@@PrevMedHealth I looked at CAC test for any mention of soft plaque/inflammation and the only thing other than the calcium score was "There is a calcification in the pericardium near the apex. There is left lower lobe scarring. There are small hypodensities noted in hepatic dome too small to characterize."

[@nbfazel]

@@PrevMedHealthDr. Brewer, Whenever you have a moment, I would really appreciate a response to the question below regarding how to determine whether I have plaque. I mentioned CITM to my cardiologist today and he poo-pooed it. He said that with the widowmaker kind of calcification I have (227, left anterior descending artery), the case for statins was clear-cut. He was getting kind of annoyed with me when I tried to distinguish between stable and "hot, inflamed" plaque.

[@briancrane7634]

So my A1c is 4.8 does that imply low C-Reactive protein? Or is it more complicated?

[@PrevMedHealth]

If A1c is higher, it implies that there are other things wrong within the family.

[@robrae14]

Is a statin a replacement for niacin? And where does metformin fit in? Who would you prescribe either to? Thanks!

[@allenmiller2071]

I have used niacin to reduce my cholesterol. Not only did it reduce my LDL and triglycerides substantially, but it also raised my HDL by 25%. You have to use the full flush niacin. I started out small and increased the dosage to 3x1000mg a day. You get use to the flush. I took one just before bedtime and was asleep when the flush occurred.

[@PrevMedHealth]

Statins & niacin are not the same. For example, niacin raises HDL. Statins don’t. Niacin doesn’t lower ldl as much as statins. We recommend low dose statins for lab- indicated inflammation for those that tolerate them. If a patient has plaque on CIMT, that’s also evidence s/he has had inflammation at one point - and could have it again.

[@tomd790]

As far as metformin goes, most docs it seems will wait until the later stages of pre-diabetes into full-blown diabetes before they prescribe metformin. If you are pre-diabetic, your doctor may well prescribe metformin if you specifically ask for it. Getting an OGTT done first is a great way to understand if you have more IR than is evident from just a fasting blood glucose test. A good number of adults these days are undiagnosed pre-diabetics.

[@robrae14]

@@tomd790 I had the OGTT 15 months ago.

[@robrae14]

@@PrevMedHealth ok cool. Inflammation labs are decent not perfect. No plaque shown on CAC or CIMT. THANKS

[@mortiesmith9686]

Now you have me a little concerned my cardiologist just put me on 40 mg of Rosuvastatin. I see nothing on my blood work for testing c reactive protein. My lipids are normal. Is 40 mg too high?

[@tomd790]

Your cardiologist might quote a study indicating that 40 mg of rosuvastatin produced a positive result for people with a sub-optimal lifestyle (often with lots of IR, diabetic tendency, hypertension, and lipid issues). If you have a lifestyle now that reduces your future risk, maybe a good time to talk with the cardiologist about getting an inflammation and advanced lipid panel along with OGTT which if all are good then potentially lowering the dose (easy to cut a 40mg tablet in half).

[@PrevMedHealth]

Good point!

[@geoffreystone4849]

Dr Rhonda Patrick has addressed the link between gene expression and polymorphism and diet and its effectiveness. She goes a long way to explaining why some folks respond differently to sugar, LDL, LCHF, vitamin D3 and other preventative measures. Studies cannot afford to do the testing required to categorise these folks and identify the genes. She mentions tests you can do what genes you have and what diet and CVD prevention you should follow. This is a great video but fails in that it is generalising in recommending statins. LDL will rise on LCHF diets. D3 absorption is affected by your genes so get it tested. Watch her series of videos.