31 July 2012
The Price Is Right?
Oh, is it that time of the year again ? Yes, it’s Polypill time again.
It is nearly a decade since we first started hearing about the polypill as a preventative of cardiovascular disease. Since then, it’s gone through an almost annual see saw of “Oh yes it is!” followed by “Oh no it isn’t!”
In 2012, the polypill flavour was good as a report from Queen Mary University in London saw reductions of blood pressure of 12% and LDL of 39% in people taking the polypill, which this time contained three blood pressure lowering drugs and one cholesterol lowering drug. “On average those who benefit (about 1 in 3/4) would gain 11 years of life without a heart attack or stroke.” “Up to 94,000 fatal or non-fatal heart attacks or strokes would be prevented”. That’s pretty impressive.
As usual, such information was greeted with a chorus of: “more evidence needed” (after 10 years?), “medicine is not a substitute for living a healthy lifestyle” (no-one said it was).
There is a built-in prejudice against mass medication. Look at the fuss that raged over fluoride in the water. And yet we mass-medicate all the time. Every single medication that is prescribed for anything in anybody is a form of mass medication.
Even the most effective treatment in cardiovascular disease (aspirin following a myocardial infraction) carries a numbers needed to treat of 12 which means that 12 people have to be treated for a period of five years to prevent one myocardial infarction. This means that, although one heart attack has been prevented in one of 12 people, you don’t know which person is the lucky one.
The researchers even suggest that the polypill should be available over the counter which, at least would avoid dismal jimmies refusing to prescribe it and leave us all to make up our own mind.
Surely the time has come to bite the bullet. Either go for it or forget the whole thing. The time has passed for yet more research. Life is more important than that.
Learn more on our CVD Management distance learning course.