A new study suggests that healthy people might benefit from taking cholesterol drugs, even if they don’t have high cholesterol or any risk factors for heart disease. Healthy people who took the drug suffered from fewer heart attacks than people who did not.

This sounds like great news, but caution is warranted before we put our entire adult population on Crestor to prevent heart attacks. From a public health perspective, it’s desirable to see a population-level improvement in health outcomes before you implement any kind of prevention program. For example, there is a clear, measurable population-wide effect of folic acid supplementation during the early stages of pregnancy, and a smaller, although still measurable effect of folic acid supplementation before conception — in both situations, the rates of spina bifida and similar birth defects are dramatically decreased. If only some people, or only a very small number of people benefited from taking folic acid supplements, then the CDC’s controversial “all women, every day” folic acid advisory would be unwarranted. But the decrease in the number of babies born with spina bifida when their mothers have taken folic acid is so very, very large that the advisory makes sense (although it has been handled ham-fistedly).

What’s this got to do with Crestor? Well, on the basis of the above study, you might think that everyone should take Crestor to reduce their risk of heart attack, regardless of what their specific risk factors for heart attack are. You might think that the someone should sponsor a media campaign to educate the public and doctors about this fantastic new finding. But look at the reported results — 120 people would have to take the drug for 2 years to prevent a single heart attack. Getting more sleep, eating more leafy greens or getting 30 minutes of exercise every day would prevent more heart attacks than that. This study has not demonstrated a large enough, population-level effect to justify the billions that a population based prevention campaign would require.

That said, you should of course make your own health decisions in consultation with your doctor. I’m not telling you to not take Crestor or any other drug. I’m just saying that an anti-cholesterol drug regimen as a prevention therapy doesn’t make sense from a public health perspective.