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Last Updated: Thursday, 26 June, 2003, 09:30 GMT 10:30 UK
'Miracle heart pill' for all
Six different medications could be combined in a single pill
Everyone over 55 should take a 'miracle pill' which could cut their risk of having a heart attack or a stroke by 80%, researchers say.

The pill would combine aspirin, a cholesterol lowering drug, three blood pressure lowering drugs and folic acid.

Patients would have to have an initial check-up from a doctor before they were prescribed the pill.

It is estimated one in three people could gain up to 20 years of life without a heart attack or stroke through taking it.

A 'polypill' should never be a licence for people to lead unhealthy lifestyles
Sir Charles George, British Heart Foundation
The pill could cost less than a pound a day, and cause minimal side effects.

It could also be given people with existing high blood pressure, heart disease or diabetes to prevent them suffering further ill health, say researchers.

The UK researchers behind the 'polypill' claim it would have "a greater impact on the prevention of disease in the Western world than any other intervention".

But they stress much more research needs to be carried out before the pill would be available to patients.

Heart attacks, stroke, and other preventable cardiovascular diseases currently kill or seriously affect half the British population."

Public health benefits

The researchers looked at evidence on the individual drugs from 750 studies covering 40,000 people.

A patient's view
Bob Bryant, now 56, had the first of his six strokes 16 years ago.
He now has to take eight separate pills each day, including cholesterol-lowering drugs and aspirin.
Mr Bryant, from Runcorn, Cheshire, said: "The idea of just taking one pill suits me down to the ground.
"That would be manageable, and it would save me all my prescription costs as well."
Based on this evidence, Professors Nicholas Wald and Malcolm Law from the Wolfson Institute of Preventative Medicine have designed a combination which they say would help reduce risk factors for cardiovascular disease.

It could reduce blood pressure and cholesterol levels.

It could also cut levels of a blood chemical called homocysteine which can build up into dangerous plaque in blood cells and improve the function of small blood cells called platelets.

Professors Wald and Law say taking a single daily pill containing the six components would prevent 88% of heart attacks and 80% of strokes.

They say the drug would not be suitable for those with asthma, who cannot take betablockers (a type of blood pressure-lowering drug), and people who cannot take aspirin.

The researchers estimate even if 10% of people could not tolerate the drug, it would still have considerable public health benefits.

Trials of the combined 'polypill' are now being planned.

Combined effect

Professor Nicholas Wald told BBC News Online why he and Professor Law had devised the polypill.

"It's only recently that it has been recognised that these treatments are as effective as they are.

"And there has also been a recognition that there's no safe level of blood pressure or cholesterol - the lower the better.

"So selecting people for treatment because they have high levels is illogical and inefficient."

Professor Wald said he did not see the pill as an alternative to addressing lifestyle factors such as smoking or obesity.

"I don't see them as mutually exclusive. Of course its sensible to give up smoking.

"But I don't think the public will be so stupid as to think if they are taking the pill they can go on smoking."

'Pill for all ills'

Other experts say the bold claims could be fulfilled.

Dr Anthony Rudd, a stroke specialist at St Thomas's Hospital, London, said: "It may well be the way forward. It would be particularly welcome for me as a stroke physician, because I could give it to people who have already had a stroke."

But he said: "Each of the individual drugs, which they have carried out clinical reviews on, has been shown to be effective.

"But we don't know what effect putting them all together in one tablet produces."

Jerry Doyle of the Stroke Association, said: "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.

"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."

Professor Sir Charles George, medical director for the British Heart Foundation, said: "There is no doubt that the idea of a 'pill for all ills' is enticing but whether we like it or not the rising tide of obesity, inactivity, diabetes and continued smoking rates cannot be ignored.

"A 'polypill' should never be a licence for people to lead unhealthy lifestyles - known risk factors will always compete with progress in medicine and can lead to other debilitating conditions such as cancer, arthritis, and bronchitis."

Professor Nicolas Wald, Wolfson Institute
"It would have a very big preventative effect"

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