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Increased Mortality Rates in the JUPITER Trial

surprising that total mortality was increased in JUPITER compared to other comparable primary prevention studies. Dr. Serebruany further fails to recognize that mortality was elevated among all participants in JUPITER and that the trial was randomized and double-blind in its design. All deaths were adjudicated by an independent endpoint committee with full access to relevant patient data, but blinded to treatment arm. As such, the statistically significant 20% reduction in allcause mortality observed among those allocated to rosuvastatin could not be due to any differential reporting of outcomes. Dr. Serebruany [1] fails to recognize several relevant issues in his discussion of increased mortality rates in the JUPITER [2] trial. First, JUPITER participants were on average 8–10 years older than those randomized into the earlier WOSCOPS and AFCAPS/TexCAPS trials. Second, 57.4% of the JUPITER cohort had hypertension, not 0% as Dr. Serebruany incorrectly states. Third, a large proportion of the JUPITER trial had impaired fasting glucose and 41% had metabolic syndrome. Fourth, all JUPITER participants had elevated levels of hsCRP, a potent predictor of mortality [3] . Given these facts, it is not Received: December 16, 2011 Accepted: December 16, 2011 Published online: February 15, 2012