The major public health concern worldwide is coronary heart disease, with 
dyslipidemia as a major risk factor. Statin drugs are recommended by several 
guidelines for both primary and secondary prevention. Rosuvastatin has been 
widely accepted because of its efficacy, potency, and superior safety profile. 
Inflammation is involved in all phases of atherosclerosis, with the process 
beginning in early youth and advancing relentlessly for decades throughout life. 
C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation 
which may reflect general health risk. Considerable evidence suggests CRP is an 
independent predictor of future cardiovascular events, but direct involvement in 
atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic 
statin with unique stereochemistry. A large proportion of patients achieve 
evidence-based lipid targets while using the drug, and it slows progression and 
induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP 
levels significantly. The Justification for Use of statins in Prevention: an 
Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after 
the observation that when both low density lipoprotein and CRP were reduced, 
patients fared better than when only LDL was lowered. Advocates and critics 
alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After 
a review, the US Food and Drug Administration extended the indications for 
rosuvastatin to include asymptomatic JUPITER-eligible individuals with one 
additional risk factor. The American Heart Association and Centers of Disease 
Control and Prevention had previously recognized the use of CRP in persons with 
"intermediate risk" as defined by global risk scores. The Canadian 
Cardiovascular Society guidelines went further and recommended use of statins in 
persons with low LDL and high CRP levels at intermediate risk. The JUPITER study 
focused attention on ostensibly healthy individuals with "normal" lipid profiles 
and high CRP values who benefited from statin therapy. The backdrop to JUPITER 
during this period was an increasing awareness of a rising cardiovascular risk 
burden and imperfect methods of risk evaluation, so that a significant number of 
individuals were being denied beneficial therapies. Other concerns have been a 
high level of residual risk in those who are treated, poor patient adherence, a 
need to follow guidelines more closely, a dual global epidemic of obesity and 
diabetes, and a progressively deteriorating level of physical activity in the 
population. Calls for new and more effective means of reducing risk for coronary 
heart disease are intensifying. In view of compelling evidence supporting 
earlier and aggressive therapy in people with high risk burdens, JUPITER simply 
offers another choice for stratification and earlier risk reduction in primary 
prevention patients. When indicated, and in individuals unwilling or unable to 
change their diet and lifestyles sufficiently, the benefits of statins greatly 
exceed the risks. Two side effects of interest are myotoxicity and an increase 
in the incidence of diabetes.