Monday, August 13, 2007
polypill (uit: Senior journal.com
New Pill Could Reduce Heart Disease by 80%, Say Researchers
June 26, 2003 - A single pill taken by everyone over 54 years old could reduce heart attacks and strokes by over 80 percent, according to researchers who are publishing their findings this week in the British Medical Journal.
Professors Nicholas Wald and Malcolm Law propose that a single pill containing six active components - aspirin, a cholesterol lowering drug, three blood pressure lowering drugs at half standard dose, and folic acid - taken daily by everyone from age 55 would have a huge impact on the prevention of disease in the Western world.
Their radical strategy is based on evidence from over 750 trials involving 400,000 participants. Each component of the "Polypill" would reduce one of four cardiovascular risk factors (high blood cholesterol, blood pressure, blood homocysteine levels, and platelet function).
Heart disease is a worldwide scourge. The American Heart Association estimates that in the United States alone, 61.8 million people had some form of cardiovascular disease in 2000 and that almost 1 million people died from it.
Coronary heart disease, which is caused by narrowing of the coronary arteries, is the single leading cause of death in the United States and was responsible for more than 500,000 deaths in 2000. Almost 13 million Americans have a history of heart attack, angina or both, and more than 1 million Americans will have a heart attack this year.
"The idea, supported by lots of evidence, is that if all of us at 55 take the Polypill that has six ingredients then 80 percent of heart attacks and stroke could be gotten rid of," Dr Richard Smith, the editor of the British Medical Journal (BMJ), told a news conference on Thursday.
He described the radical new proposal for dealing with cardiovascular disease, which accounted for 16.6 million or one third of global deaths in 2001, as "a step of genius."
"Because the ingredients are, or are about to be, off patent, this could be an extremely cheap and simple pill," Smith added.
Half of all people will develop heart disease if they live long enough, according to Wald who reported the findings in the BMJ.
The pill would be suitable for people aged 55 and older and many people with existing high blood pressure, heart disease or diabetes. It need not be expensive and should be safe with minimal side effects.
They say their preventive approach would result in one-third of people over 55 gaining, on average, 11 years of life free from such problems.
Trials of the "Polypill" are planned, to see if the combination is safe and effective, and may take several years.
The authors suggest that the pill would be taken without a medical examination or measurement of risk factors as treatment would be effective whatever the initial levels of the risk factors. They say their preventive approach would result in one-third of people over 55 gaining, on average, 11 years of life free from such problems
"Clearly, there's a fairly large issue as to whether in our society it makes sense," says Dr. Richard Stein, associate chairman of medicine at Beth Israel Hospital in New York City and a spokesman for the American Heart Association. "They're proposing it really for developing countries where testing [for heart disease] is not available or is too expensive."
It is time to discard the view that risk factors need to be measured and treated individually if found to be "abnormal," say the authors. Instead it should be recognised that in Western society the risk factors are high in all of us, so everyone is at risk. There is much to gain and little to lose by the widespread use of these drugs, they conclude.
So, is this bold conclusion justified? Quite possibly, says Dr. Anthony Rodgers in an accompanying editorial. Despite widespread perceptions, these medications are extremely safe and well tolerated � new problems seem unlikely since they have been studied so extensively and used so often together. Realising their enormous potential should be a major goal.
