Polypill 'will give over 50s years more healthy life'

 By Stephen Adams, Medical Correspondent

The pill, which reduces blood pressure and cholesterol, would cut the risk of heart attack by three quarters and a stroke by two thirds, they found. 

Every year up to 200,000 people die of cardiovascular disease but if everyone in the UK over 50 took the pill that number could be more than halved, according to scientists from Queen Mary, University of London. 

The polypill, that could cost 50p a day, contains three blood pressure-lowering drugs and a cholesterol-lowering statin. 

Statins have for years been prescribed to people deemed at high risk of heart attack or stroke, but who have never had one. So too have blood pressure lowering drugs. 

But many struggle to take both daily, reducing their overall effectiveness. The idea behind the polypill is to make the whole process of preventive medicine much easier. 

In a trial over three months, the polypill was found to cut blood pressure by 12 per cent and lower levels of "bad" cholesterol by 39 per cent. 

Scientists already know that bringing down cholesterol and blood pressure levels lowers the chance of heart disease and stroke. 

They can predict with reasonable accuracy just how much lowering these two factors reduce the risk of a cardiovascular event. 

The team consequently predicted that the polypill would reduce the risk of heart disease events by 72 per cent and stroke by 64 per cent. 

But not all benefit: some who take the pill would still suffer a heart attack or stroke, while for others such an event would be delayed. 

Dr David Wald, the cardiologist who led the research, explained: "The health implications of our results are large. If people took the polypill from age 50, an estimated 28 percent would benefit by avoiding or delaying a heart attack or stroke during their lifetime," he said. 

"On average, those who benefit would gain 11 years of life without a heart attack or stroke.” 

For some people, that would mean potentially fatal heart attacks and strokes being delayed by that length of time, he said. 

The polypill should be made available over the counter "without delay", he argued. 

"When something like this is developed it should be made available as quickly as possible. How people pay for it is a judgment society needs to make," he added, saying the polypill could be approved by medical regulators in just two years. 

The version of the polypill that they tested contained the blood pressure drugs amlodipine, losartan and hydrochlorothiazide together with cholesterol-lowering simvastatin. Aspirin - included in earlier formulations - has been dropped because it can cause stomach bleeds. 

A group of 84 men and women aged 50 and over were randomly given the polypill or an inactive "dummy" tablet for a period of three months. 

They then switched treatments for another three months so the effects of both were seen in each patient. The results are published in the journal PLoS One. 

Dr Wald’s father, Professor Sir Nicholas Wald, who came up with the polypill concept, said the pill could be dispensed by trained pharmacists or nurses after checking recipients were suitable. 

"There should be an assessment, but I don’t think a physical assessment by a doctor is necessary," he said. 

"Even if only 50 per cent of people aged 50 or more took the polypill, about 94,000 fatal and non-fatal heart attacks and strokes would be prevented each year in the UK." 

However, Natasha Stewart, senior cardiac nurse at the British Heart Foundation, sounded a note of caution. 

"Research into polypills is encouraging, but there are still many questions to answer before this ‘wonder drug’ is prescribed by doctors. 

"However interesting this potential new pill is, medicines are not a substitute for living a healthy lifestyle. Staying active, eating healthily and not smoking are still vital ways to help keep your heart in good shape." 

Dr Margaret McCartney, a Glasgow GP whose book The Patient Paradox asks why doctors end up screening healthy people rather than treating sick ones, said more evidence was needed before a mass programme was embarked upon. 

"The history of medicine is rich with ideas that sounded great but either didn’t prove effective - or worse, did harm," she said. 

"Because of this, we need trial evidence that looks at real life outcomes like death rates - not just biochemical numbers. 

"We also have increasing evidence that well women, for example, don't benefit from statins - meaning that we may only be offering them side effects- and while muscle aches might seem like a minor side effect, if it stops someone walking or socialising it becomes major. 

"We need much larger trials that gives us fair representations of risk and harm - and that's independent - separate from patent holders." 

Prof Wald is a patent holder for this version of the polypill. 

She said: "The people least likely to benefit from the polypill - the healthy - will probably be the most likely to take it." 

And she argued: “We also risk losing sight of the things that we need to change to benefit everyone in the community - like addressing obesity, health inequalities, poverty and safer cycling.” 

“I don't like the answers to these problems lie in a pill - and our increasing reliance on medicine to solve social and political problems ends up offering 'answers' to issues it can't possibly solve.” Telegraph