Daily Pill Proposed to Fight Cardiovascular Disease
(Inserted statements in orange are HS editorial comments)
Two British scientists have proposed a radical strategy for preventing cardiovascular disease: a daily pill that would be prescribed to nearly all people older than 55, regardless of their risk of heart attack or stroke.
(This news release gets the HS award as the ‘nonsense medical story’ of the month. The pharmaceutical companies are at it again – hard at work trying to expand their markets - this time to the not-yet-sick. What a potentially profitable strategy!)
The polypill, as the scientists called it in a paper published in late June in the British medical journal BMJ,
has yet to be created.
It would contain six drugs: a cholesterol-lowering statin; three blood-pressure medications; folic acid, which is thought to reduce homocysteine, a risk factor for heart disease; and aspirin, which can prevent heart attacks. Taking the pill would lower the risk of heart attack by 88 percent and of stroke by 80 percent, the scientists said.
(Note: there’s no such pill yet, so no clinical testing has been possible, no case histories, no outcome data, but they’ve predicted a precise favorable outcome nonetheless.)
Because many people stand little risk of cardiovascular disease, the pill would not help everyone.
(Possibly no one…)
Still, the scientists said, a third of those taking it would benefit, gaining an average of 11 years free of cardiovascular disease.
"What you're trying to do with this pill is reduce all the risk factors for cardiovascular disease at once," said Dr. Nicholas Wald, an epidemiologist at the University of London who wrote the paper with Dr. Malcolm Law, another epidemiologist at the university. "And you want the maximum reduction that is consistent with safety."
But Dr. Paul M. Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston, argued against mass prescription of such a pill.
"The risk-to-benefit ratio of any medication has to be sorted out by individual patients and their physicians," Dr. Ridker said. Dr. Robert O. Bonow, president of the American Heart Association, said that mass treatments could mean undermedicating some while exposing others to unnecessary risks of side effects. Aspirin, he noted, can cause bleeding complications. "We know that if you give aspirin to everyone, you don't save any lives at all," Dr. Bonow said. "The lives you save by preventing heart attacks and strokes are offset by the lives you lose from bleeding."
(At last, some words of medical sanity.)
Dr. Wald admitted there could be some downside to the polypill – "Eight percent to 15 percent of those who taking the pill could be expected to suffer effects from the ingredients, like fatigue, vivid dreams or a cough," he conceded.
(Dr. W. forgot to mention that a not-often mentioned side effect of ALL drugs is death..)
In an editorial accompanying the proposal, Dr. Anthony Rodgers of the University of Auckland in New Zealand called the strategy bold and deserving of consideration. But, he said, doctors would have to determine whether the combination of six drugs would produce unexpected side effects.
Dr. Ridker and Dr. Bonow argued that a better approach was increasing healthy habits. "The magic pill I would really like to see is one that would motivate our patients to diet, exercise and stop smoking," Dr. Ridker said. "You would get far greater reductions in heart disease than we can get from any of these medications."
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