Feature Preventive Medicine

What happened to the polypill?

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1822 (Published 26 September 2008) Cite this as: BMJ 2008;337:a1822
  1. Geoff Watts, freelance journalist
  1. 1London
  1. geoff{at}scileg.freeserve.co.uk

    A single pill to prevent cardiovascular disease sounds like a perfect solution, but little progress has been made since the idea was first suggested. Geoff Watts investigates why

    When Nicholas Wald, head of London’s Wolfson Institute of Preventive Medicine, and his colleague Malcolm Law published their case for the prevention of heart disease using a “polypill”,1 an accompanying editorial described it as “one of the boldest claims for a new intervention.”2 The substance of the claim was that, if taken by everyone with established cardiovascular disease and—most importantly—all those aged 55 or over, the polypill could reduce rates of heart attack and stroke by more than 80%.

    Now, more than five years later, you might imagine that a clutch of research groups would be eagerly competing to test this innovative suggestion. Not so.

    As conceived by Professors Wald and Law, the polypill comprised a statin, aspirin, three types of blood pressure lowering drug, and folic acid—intended to lower serum homocysteine concentrations. The logic was that most people in Western society are at raised risk, that cardiovascular disease is consequently common, and that the drugs …

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