Bold claims have been made about the polypill, can it live up to expectations?
A new study assessing the benefits of taking the polypill – a medication intended to ward off heart disease – suggests that it could potentially prevent thousands of heart attacks and strokes. However, the study’s results, which generated a lot of headlines when it first appeared, are not as clear-cut as they might seem. Researchers from Queen Mary, University of London looked at the effects of taking the polypill for individuals aged over 50, none of whom had a history of heart disease. This was a cross-over trial, meaning that all the participants took the polypill and a placebo but during different time periods. Each participant had three months on the polypill and three months on the placebo; some took the polypill first, others the placebo. This method allowed the researchers to assess the benefits for each individual – comparing an individual’s physical response to the polypill to their response to the placebo – rather than one group against another, which provides greater accuracy.
The polypill used for this study works on different levels: it targets blood pressure with three different medications, and also contains a statin to lower cholesterol. With high blood pressure and high levels of LDL cholesterol being precursors to heart disease, a reduction in these areas should also significantly reduce the likelihood of heart disease. And the researchers found that taking the polypill resulted in a 12% reduction in blood pressure and a 39% lower LDL cholesterol level. These are the equivalent levels, on average, of a person around 30 years younger than the study participants. This, say the researchers, indicates that the incidence of heart attacks in the over 50s could be avoided or delayed by as much as 28%, if they were taking the polypill.
It would seem sensible then, to offer this polypill to everyone over the age of 50. But the results shouldn’t be interpreted so quickly or easily. The study, which was funded in part by the pharmaceutical company Cipla, was co-authored by the same individual who holds the patent for the pill. The study looked at only 84 individuals – an aspect of the study many newspapers failed to report on – and so extrapolating from the study results that the pill could help prevent thousands of deaths is premature, say spokespeople from the NHS. Furthermore, the study did not take into account – or analyse – potential side effects from taking the medication. Large-scale studies and, importantly, long-term studies need to be undertaken so that the polypill’s benefits can be fully understood and decisions can be made as to whether it should be made available to everyone. In the meantime, the best advice you can follow is to live as healthily as possible – a diet rich in fresh vegetables, fruit and wholegrains, plus regular exercise is by far the best way to prevent heart disease.