'Polypill' Could Cut Heart Attacks By 80%

The Guardian (UK) ^ | 6-26-2003

[blam]

'Polypill' could cut heart attacks by 80%

Press Association
Thursday June 26, 2003

A single pill containing aspirin, folic acid, and drugs to lower blood pressure and cholesterol could cut heart attacks and strokes by more than 80%, a new study revealed today. The "polypill" could advance disease prevention in the western world more than any other single medical invention, according to researchers writing in the British Medical Journal.

If taken daily by people over 55 and those suffering from cardiovascular problems, it could dramatically reduce the incidence of strokes and heart disease.

About one in three people would benefit to the tune of 11-12 years of extra life without cardiovascular complaints.

Preventable cardiovascular diseases currently kill or seriously affect half the UK population.

Trials of the pill are now planned, to see if the combination is safe and effective. These could take several years.

Professor Nicholas Wald, of the Wolfson Institute of Preventative Medicine in London, and Malcolm Law, of the University of Auckland in New Zealand, had set out to find a combination of drugs and vitamins which could help prevent cardiovascular disease with few side effects.

Researchers looked at data from 750 trials involving 400,000 people.

They came up with a pill containing six active components: aspirin, folic acid, a cholesterol-lowering drug and three drugs to lower blood pressure at half the normal dose.

They concluded that their so-called polypill could prevent 88% of heart attacks and 80% of strokes, with each element of the pill working to reduce one of four cardiovascular risk factors.

The researchers point out that the pill need not be expensive, and should be safe with few side effects. It could be taken without the need for a medical examination or any individual measurement of risk factors, they said.

"As stroke is one of the biggest killers and the largest cause of severe adult disability in the UK, we encourage any research and development of treatment that will reduce the chance of suffering a stroke, and await the outcome of these trials with interest," said Jerry Doyle, of the Stroke Association.

"However, it is also important for people to know that they can reduce their risk of stroke by having their blood pressure checked regularly, taking exercise, eating a healthy diet and by giving up smoking," he added.

Prof Wald said the polypill was not intended to make such good advice redundant.

"It is a complimentary measure. Indeed, if we all had the right diet from the day we were born, it would not be needed. But changing the diet of an entire nation is impractical," he said.

He said the pill could prevent 200,000 premature deaths in the UK each year. Anyone over 55 given the pill could expect to feel the full benefits of it within three to four years, he added.

The cost of the pill has not yet been calculated, but Prof Wald said it could be less than £1 a day.

When asked about the ethics of medicating large sections of the population who were currently healthy, Richard Smith, the editor of the BMJ, pointed out that many people already take multivitamins without being certain of their benefit.

But Prof Wald admitted it could be difficult to get the required backing from the drug industry for the pill to be produced and marketed.

"Pharmaceutical companies need to make money and the concept of the polypill for some will erode their existing market," he said.

[blam]

I presently take one baby aspirin (81mg) twice a day and a cholestoral lowering drug.

[Cicero]

I also take one 81mg tablet of aspirin a day, and 20 mg lipitor. Plus a teaspoon of emulsified codliver oil (which doesn't have that horrible taste).

My doctor says the aspirin is just as important as the lipitor. I don't recommend lipitor unless you need it, because it could have side effects, but aspirin is cheap and available without a prescription. If you look around you can find bottles of 81mg aspirin that is NOT baby aspirin and therefore much easier to take.

[Cicero]

Hmm. I also take something called B-50 tablets on my daughter's recommendation. It's a combination of B vitamins--i.e., folic acid.

As I said before, I wouldn't mess with lipitor without a doctors strong recommendation; but you can take everything else this "polypill" includes without a prescription. I would include the cod liver oil because I think it helps the balance of "good" cholesterol vs. "bad" as well as giving you a healthier balance of kinds of fat.

[blam]

"I also take one 81mg tablet of aspirin a day, and 20 mg lipitor."

I tried Lipitor, it kept me awake all the time. I presently take 20mg of lovastatin without the insomnia.

[DoughtyOne]

You guys have the right idea. I take a 162mg enteric coated aspirin once per day. It goes down easy and after 40 is one of the single best things you can do for yourself short of exercising.

Some physicians consider aspirin a good first response if you fear you've suffered a heart attack.

Aspirin has been found to have a large number of beneficial side effects. Look into it some time. It's interesting.

[blam]

"I also take something called B-50 tablets on my daughter's recommendation. It's a combination of B vitamins--i.e., folic acid."

I used to take B-50 also. Now I eat brocchli and fish 3-4 times a week. I eat so much fish that I got a test for heavy metals, mercury was my concern. The tests showed I had low levels of all heavy metals, for mercury I had a 2.0 on a 0-15.0 acceptable level scale.

[Keith in Iowa]

Anything in the Statin family (Lipitor, Zocor, etc...)can be horrible for some people...and it wasn't too good for me. Lipitor gave me terrible tinitus, gave me symptoms similar to a diverticulitis attack, and made me darn-near loose the use of my right arm from muscle pain/weakness. I quit taking it. I see the doctor next week, who's probably going to scold me about my cholesterol levels...but there's no way in he** I'm going to take any statin.

[blam]

"Aspirin has been found to have a large number of beneficial side effects. Look into it some time. It's interesting."

Yup, read all about it. My dad died of a heart attack, my older brother died of a heart attack at 51 and my younger brother had a heart attack and then a stroke at age 51 and is presently confined to a nursing home. The genetic odds are against me. I do every thing right.

[Ditter]

I have started taking Zetia for high cholestrol. It doesn't have the bad side affects of Lipitor & it has dropped my cholestrol from 305 to 214 in 4 weeks. I go back for another blood test in 2 months. I take a full strength aspirin daily.

[blam]

". I see the doctor next week, who's probably going to scold me about my cholesterol levels...but there's no way in he** I'm going to take any statin."

I tried all those too. Ask for Lovastatin, nothing else suited me either. I have no known side effects, I'm amazed especially with the problems I had with all the others.

[Keith in Iowa]

>>Ask for Lovastatin...

I'm not going to take anything from the statin family. I'm going to ask about Zetia & Niaspan.

[blam]

"I'm not going to take anything from the statin family. "

I understand, I said exactly the same thing and got talked into trying Lovastatin. (One last chance, lol)

[Ditter]

Please check out Zetia. I have many drug allergies. The Dr. gave me Zetia because it doesn't cause any known problems. It has worked great for me so far.

[Mike Darancette]

About one in three people would benefit to the tune of 11-12 years of extra life without cardiovascular complaints.

What will the people die of then?

My wife asks me why all these people are getting Alzheimer's and getting weird Cancers. My answer is because we have licked Tuberculosis, Yellow Fever, Small Pox and other diseases of yore.

Ya Gotta die of something. The average life expectancy is going up but the maximum number of years allowed to man are about what they were 5,000 years ago.

[blam]

Go here for the side effects of Zetia. Sure sounds like you're having good success with it.

[blam]

"The average life expectancy is going up but the maximum number of years allowed to man are about what they were 5,000 years ago."

LOL. I did notice that Kennewick Man, Spirit Cave Man and Otzi(The Ice Man) all died in their mid-40's.

[B-bone]

but you can take everything else this "polypill" includes without a prescription.

"They came up with a pill containing six active components: aspirin, folic acid, a cholesterol-lowering drug and three drugs to lower blood pressure at half the normal dose. "

It wasn't mentioned in this article what these three drugs are, but they are almost certainly prescription items at least at this time. This sounds like the ultimate combination pill, 6 medications in 1 pill.

If you are looking to increase compliance, and that is the idea behind combination medications---other than patent extention and marketing which is a whole different discussion--this is where these things are heading.

[B-bone]

In follow up, I reviewed the article in the BMJ which prompted the news story. The proposal was to use three blood pressure lowering drugs (for example, a thiazide, a blocker, and an angiotensin converting enzyme inhibitor. Common examples of these are HCTZ, Tenormin (atenolol) or Lopressor (metoprolol), and Prinivil/Zestril (lisinopril) or Vasotec (enalapril) respectively.

These are probably the most common combinations of agents for blood pressure treatment and have a low incidence of side effects particularly at low doses which are being proposed.

I suspect the dosage of lipitor they were suggesting for a pill like this is 10 mg. This is a low dose with a low incidence of side effects, but as many on this thread have indicated, the operative word is LOW, not Non-existant.

From a public health standpoint--how to lower the incidence of a given disease in a large population--this approach makes sense. From an individual patient's perspective, as you noted, it's not a free lunch.

[B-bone]

Sorry, I forgot to post the link to the British Medical Journal (BMJ) article if anyone is interested.

A strategy to reduce cardiovascular disease by more than 80%? (paper)

A cure for cardiovascular disease? (editorial)

The editorial would probably be the more interesting of the two links for the layman as it explains, in what passes for english in medical circles, why they are trying this. (The writer of the news story relied heavily on the editorial--which is appropriate)

[B-bone]

I suspect the dosage = The dosage

I hit post rather than preview.