BMJ  2003;327:809-810 (4 October), doi:10.1136/bmj.327.7418.809-a

Letter

"Polypill" to fight cardiovascular disease

Authors' reply

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

EDITOR—Your correspondents overlook the extent of the health gain achievable with the "Polypill" and of the large amount of evidence underpinning our estimates of efficacy and adverse effects.¹

About one person in three would benefit, and the Polypill would offer many people important extra years of active and useful life, with benefits evident over decades. The adverse effects, on the other hand, would mostly be apparent after a few weeks, in which case a variant of the pill could be substituted—for example, one without aspirin.

Of course, the Polypill is not an alternative to adopting a healthy lifestyle such as not smoking or not becoming overweight: it is a complementary means of prevention. We agree that work on the Polypill needs to continue so that after the necessary clinical trials it can be made available.

Ramos's view, that medicine should remain a patient based practice, is too limited; . . . [Full text of this article]

n.j.wald@qmul.ac.uk

Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London, London EC1M 6BQ

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