Jeremy Laurance: Can such a simple idea save thousands of lives?

Share
Related Topics

Few ideas are simple in medicine but none is simpler than the polypill. A combination of five medicines in a single capsule, taken once a day, would be easy to remember, easy to take and, on the strength of the trial reported in today's Lancet, effective.

Could such a simple idea really save hundreds of thousands of lives? Yes. For a simple reason. Although the five medicines that make up the polypill – aspirin, statin and three blood-pressure drugs – are already taken by millions of people in Britain and around the world, there are millions more who ought to be taking them but aren't.

These are the people who are at high risk of heart disease but don't know that they are because they don't have any of the recognised risk factors – being overweight, a smoker, having high blood pressure, high cholesterol or a family history of heart disease.

They lack any of the risk factors but they account for one third of all heart attacks – 80,000 a year in Britain. Yet they are being entirely missed by the current approach which focuses treatment on those identified as being at high risk.

The solution, proposed six years ago by two British specialists in the BMJ, is simple: treat everyone. Give all those over a certain age the polypill whose five constituent medicines are tried and tested and have few side effects. The proposal has been likened to a vaccine for the middle-aged with this difference: unlike a vaccine which might benefit one in 1,000 of those who receive it, the polypill would benefit one in three of those who take it.

But it faces three challenges. First, more evidence is required that it can save lives and funding must be found for the necessary trials to grant it a product licence. The lack of interest from the major companies involved in drug research is an indictment of the profit-based pharmaceutical industry.

Second, it must overcome criticism from some doctors that such a pill could be used as a licence for people to lead unhealthy lifestyles. The fear is that providing cardiovascular protection to everyone in a pill would remove the incentive to stop smoking, go to the gym and eat a healthy diet.

Third, its proponents need to answer critics who say they are encouraging the medicalisation of everyday life. As more and more of us pop pills, there is a question of what effect mass medication would have on our collective psyche. The polypill will save lives – but at what cost?

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

KS1 & KS2 Teacher

£85 - £130 per day: Randstad Education Chester: Day to Day job opportunities f...

Primary Teachers needed in Cheshire West

£85 - £130 per day: Randstad Education Chester: Day to Day job opportunities f...

NQT Job Opportunties in Winsford

£85 - £100 per day: Randstad Education Chester: Are you a Newly Qualified Teac...

Year 3 Teachers needed for supply roles

£110 - £130 per day + Competitive rates of pay: Randstad Education Reading: Ye...

Day In a Page

Read Next
Scientists believe the discovery could lead to new treatments for loss of memory function caused by ageing and other factors  

We need a completely new approach to caring for older people

Carol Jagger
 

Daily catch-up: out of time, polling and immigration and old words

John Rentoul
Oscar Pistorius sentencing: The athlete's wealth and notoriety have provoked a long overdue debate on South African prisons

'They poured water on, then electrified me...'

If Oscar Pistorius is sent to jail, his experience will not be that of other inmates
James Wharton: The former Guard now fighting discrimination against gay soldiers

The former Guard now fighting discrimination against gay soldiers

Life after the Army has brought new battles for the LGBT activist James Wharton
Ebola in the US: Panic over the virus threatens to infect President Obama's midterms

Panic over Ebola threatens to infect the midterms

Just one person has died, yet November's elections may be affected by what Republicans call 'Obama's Katrina', says Rupert Cornwell
Premier League coaches join the RSC to swap the tricks of their trades

Darling, you were fabulous! But offside...

Premier League coaches are joining the RSC to learn acting skills, and in turn they will teach its actors to play football. Nick Clark finds out why
How to dress with authority: Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear

How to dress with authority

Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear
New book on Joy Division's Ian Curtis sheds new light on the life of the late singer

New book on Ian Curtis sheds fresh light on the life of the late singer

'Joy Division were making art... Ian was for real' says author Jon Savage
Sean Harris: A rare interview with British acting's secret weapon

Sean Harris: A rare interview with British acting's secret weapon

The Bafta-winner talks Hollywood, being branded a psycho, and how Barbra Streisand is his true inspiration
Tim Minchin, interview: The musician, comedian and world's favourite ginger is on scorching form

Tim Minchin interview

For a no-holds-barred comedian who is scathing about woolly thinking and oppressive religiosity, he is surprisingly gentle in person
Boris Johnson's boozing won't win the puritan vote

Boris's boozing won't win the puritan vote

Many of us Brits still disapprove of conspicuous consumption – it's the way we were raised, says DJ Taylor
Ash frontman Tim Wheeler reveals how he came to terms with his father's dementia

Tim Wheeler: Alzheimer's, memories and my dad

Wheeler's dad suffered from Alzheimer's for three years. When he died, there was only one way the Ash frontman knew how to respond: with a heartfelt solo album
Hugh Bonneville & Peter James: 'Peter loves his classic cars; I've always pootled along fine with a Mini Metro. I think I lack his panache'

How We Met: Hugh Bonneville & Peter James

'Peter loves his classic cars; I've always pootled along fine with a Mini Metro. I think I lack his panache'
Bill Granger recipes: Our chef's heavenly crab dishes don't need hours of preparation

Bill Granger's heavenly crab recipes

Scared off by the strain of shelling a crab? Let a fishmonger do the hard work so you can focus on getting the flavours right
Radamel Falcao: How faith and love drive the Colombian to glory

Radamel Falcao: How faith and love drive the Colombian to glory

After a remarkable conversion from reckless defender to prolific striker, Monaco's ace says he wants to make his loan deal at Old Trafford permanent
Terry Venables: Premier League managers must not be allowed to dictate who plays and who does not play for England

Terry Venables column

Premier League managers must not be allowed to dictate who plays and who does not play for England
The Inside Word: Brendan Rodgers looks to the future while Roy Hodgson is ghost of seasons past

Michael Calvin's Inside Word

Brendan Rodgers looks to the future while Roy Hodgson is ghost of seasons past