Thousands of lives can be saved by a cheap, four-in-one pill that reduces the risk of heart attacks and strokes.
A large British study showed that the daily pill with aspirin, a statin and two drugs to lower blood pressure lowers the risk by up to a third. In people without heart attacks or strokes, the risk was reduced by around 40 percent.
The idea of a "polypill" with various drugs to prevent heart disease has been around for years, but none are available in the UK. This is the first major study to confirm that polyps, which only cost 2p per day to produce, help protect all adults – even those without heart disease.
The idea of a "polypill" with various drugs to prevent heart disease has been around for years, but none are available in the UK. This is the first major study to confirm that polyps, which only cost 2p per day to produce, help protect all adults – even people without heart disease
It suggests that such a pill could be given to millions of people over 50 as a preventative measure, in the same way as statins are prescribed.
Many experts believe that a single combined pill can prevent more deaths from heart attacks and strokes, save NHS money, and provide more convenience for patients. But others are concerned that massive prescriptions, even for people without a history of problems, run the risk of turning healthy people into patients.
Today's study, published in The Lancet, followed nearly 7,000 adults for five years. Study author Professor Tom Marshall of the University of Birmingham said: "This is the largest study that confirms the value of the polypill and shows that it is effective in preventing heart disease.
"Millions of Britons already use statins and blood pressure medicines, but they can be offered one polyp instead of taking many different tablets. It is a much more convenient way to take medication. & # 39;
Birmingham researchers and scientists at the University of Tehran followed adults aged 50 to 75 who lived in Northern Iran. The participants were divided into two groups of 3,400. They were all encouraged to adopt a healthier lifestyle, but a group also got the polyps to take every day.
Study author Professor Tom Marshall of the University of Birmingham said: "This is the largest study that confirms the value of the polypill and shows that it is effective in preventing heart disease.
Researchers followed them in five years and discovered that the polypill group was 34 percent less likely to have a heart attack or stroke. This included a 40 percent reduced risk for people without a history of heart disease, and a 20 percent reduction in those who had previously had heart problems.
Participants who took the pill for five years received the best results, while those who used it most days reduced their risk by 57 percent. A total of 202 people in the group who took the polypil suffered a heart attack or stroke, compared to 301 in the group where only lifestyle advice was given.
Professor Marshall added: "The polyps can be produced very cheaply, with around 2 pence a day. They are currently made for a cent in India and would not be much more expensive to produce here. & # 39;
The research will increase the pressure on the drug to get a license for use in the UK. Many elderly patients do not adhere to prescribed regimens, including statins, blood pressure drugs, and various other tablets, reducing their effectiveness. In 2007, Professor Sir Roger Boyle, the then-hearted tsar of the government, said that mass-pill prescription would transform the health of the country and relieve pressure on the NHS.
The polypill tested by the team, produced by the Iranian company Alborz Darou, included aspirin, a statin called atorvastatin and two blood pressure drugs called hydrochlorothiazide and enalapril.
Experts welcomed the findings, but said further research was needed before a polypill was introduced in the UK. There are concerns that mass prescribing such drugs could lead many people to abandon a healthy diet and exercise in the belief that the polypill will protect them.
Professor Jeremy Pearson of the British Heart Foundation said: "This study shows that in low and middle income countries, where the use of drugs to reduce the risk of heart disease is low, a single pill combining different drugs is safe and effective. The findings are not transferable to high-income countries where preventive medical care to reduce the risk of cardiovascular disease is common at the start of the study. at least seven different medicines every day.
DR MAX PEMBERTON: A four-in-one pill that helps keep the heart healthy is a step forward – but not a magic bullet
The idea that there is a & # 39; magic bullet & # 39; is to cure illness and illness, is always popular. Although illness is often complicated, we like to think that there is a simple, one-size-fits-all answer.
This week sees the promise of yet another & # 39; magic bullet & # 39; in the form of the polypill. This is a tablet that combines four different medications that, it is claimed, could almost halve the risk of heart attacks and strokes in middle-aged and elderly people.
It contains aspirin to thin the blood, a statin to lower cholesterol and two blood pressure lowering drugs.
The polyp announced this week is the perfect lifestyle medication, but such magic bullets rarely exist
Fighting diseases requires a number of approaches. Medication is only one weapon and cannot be used alone
All these drugs are readily available, but the idea is that combining them into one tablet makes compliance easier.
The research also suggests that starting everyone in their fifties – not just those with pre-existing cardiovascular diseases – can save tens of millions of lives worldwide.
It is the perfect lifestyle medication; easy to take, few side effects and cheap. But if the history of medicine has taught us anything, it is that there is rarely a quick solution to disease – and as much as we would like, a "magic bullet" does not exist.
Fighting diseases requires a number of approaches. Medication is only one weapon and cannot be used alone.
Heart diseases and strokes are lifestyle diseases and unfortunately, although drugs can reduce their impact on our health, they cannot completely reduce the damage.
Remember that the study showed that the polypill reduced the risk of serious cardiovascular events by an average of 34 percent. When corrected for people who used other heart medication – which could also be an advantage – the protective effect of the polypill was reduced to around 20 percent.
Although this is still statistically significant, it is far from 100 percent, which means that it is not fully protected and that without lifestyle changes, people are still at risk. Although I broadly welcome this pill, it should only be seen as an addition to other attempts to reduce the risk of heart disease and stroke.
There is concern that such a pill, praised as a panacea for two of the greatest murderers in the Western world, will make people complain about changing their lifestyles.
This pill offers a reductive picture of disease. It focuses on just one consequence of an unhealthy lifestyle, while there are many. The tablet can lower your cholesterol, but without lifestyle changes that have led to it, there is still a risk of diseases such as cancer.
Unless you make changes to your diet, you can still be overweight and therefore at risk for diabetes, which in turn can lead to blindness, kidney failure or nerve damage.
There are also very real concerns about the "medicalization of daily life". Prescribing entire populations on a tablet means that many people will receive unnecessary medication.
The research even shows that in order to save a person from a heart attack or stroke, 35 must be treated. That is fine if you are the one person who is saved, but what if you use the tablet unnecessarily?
Although I am sure that the polypill will offer some benefits, unfortunately there is no tablet that eliminates the need for a good diet and regular exercise.
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