A healthy heart in a single pill'Polypill' could curb heart disease and
stroke.
27 June 2003
MICHAEL HOPKIN
 |
| One pill would combine
existing separate drugs. |
| ©
Corbis | | |
A single pill given to everyone aged over 55 could
cut heart disease in developed countries by 80%, a group
of medical researchers say.
The treatment, dubbed the Polypill, would combine
existing drugs to create a single medicine that would
reduce the risk of heart disease and stroke. These
conditions currently account for one-third of all deaths
in the Western world.
"No other preventive measure would have such an
impact," says Nicholas Wald of the Wolfson Institute of
Preventive Medicine in London, who led the research1-3.
He estimates that it would save some 200,000 lives each
year in Britain alone.
Risky business
Four factors are thought to contribute to an
increased risk of heart disease: blood pressure, the
'stickiness' of blood platelets, and levels of
cholesterol and a chemical called homocysteine, a
suspected artery blocker. If all of these can be
reduced, Wald argues, the risk of heart disease will
plummet.
The Polypill would contain three different drugs to
reduce blood pressure, as well as aspirin to separate
platelets, statin to reduce cholesterol, and folic acid
to curb homocysteine levels. All of these drugs are
already available separately.
Although it's an enticing idea, the Polypill should
not be a licence for people to lead unhealthy lifestyles
that contribute to heart disease and stroke, says
Charles George, medical director of the British Heart
Foundation. "The rising tide of obesity, inactivity,
diabetes and continued smoking rates cannot be ignored,"
he argues.
The Polypill should also be rigorously tested. "As
with any new treatment, it will need trials to find out
just how accurate the predictions are and what
side-effects occur," he says.
Proof of the pudding
First, someone will have to make the pill to see if
it can bring about a simultaneous reduction in all four
risk factors. So far, the team's hopes for the pill rest
on combined data from more than 750 separate trials of
the individual drugs.
Wald's analysis suggests that the Polypill's
side-effects would be minimal. For example, three
blood-pressure drugs would be included at low doses, so
as to minimize their individual negative effects while
still reducing blood pressure significantly.
Although the treatment could be available within two
to five years, it may be difficult to find financial
backing, Wald admits. All of the drugs involved are
cheap and are not covered by patents. But it could
nevertheless be possible to patent the Polypill's
recipe.
Some experts question the ethics and economics of
prescribing a single medicine to an entire section of
society. But Wald argues that, in the case of heart
disease, the numbers make a compelling case. "Half of us
will suffer from cardiovascular disease," he
says. | 
