BMJ  2003;327:807-808 (4 October), doi:10.1136/bmj.327.7418.807-b

Letter

"Polypill" to fight cardiovascular disease

Universal polypharmacy goes against recent beliefs in prescribing practice

The first 150 words of the full text of this article appear below.

EDITOR—Your advocacy of universal polypharmacy—as evidenced by the paper by Wald and Law¹—is somewhat against recent beliefs in prescribing practice. Has there been sufficient emphasis on the fact that the proposal is a theoretical construct (admittedly enticing), based on extrapolation of data from many disparate studies, rather than on a trial itself? Indeed, why bother with new trials if one can find such apparently definitive answers so conveniently from existing data?

Apart from immediate practical considerations—such as a reliable source and supply system—little thought seems to have been given, among other matters, to:

• Potential adverse events (particularly in certain population groups, such as those with asthma or allergies)
  
• Duration of benefit and possible implications on further treatment should it be required
  
• The effects on those unable to tolerate such a Polypill or on the 20% who would not benefit, and how to identify them
  
• Adverse lifestyle behavioural . . . [Full text of this article]

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This article has been cited by other articles:

• Franco, O. H, Bonneux, L., de Laet, C., Peeters, A., Steyerberg, E. W, Mackenbach, J. P (2004). The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. BMJ 329: 1447-1450 [Abstract] [Full text]  

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