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Combo pill for heart health being developed

Published Aug. 27, 2005

Millions of people pop a multivitamin pill every day, getting a dozen vitamins and minerals in a single swallow. Think of the inconvenience if you had to take each nutrient in a separate pill.

Why doesn't somebody invent a combination pill that makes the control of other health problems easier to swallow? Heart patients, for instance, may need a handful of different pills every day to lower blood pressure, fine-tune blood cholesterol levels, prevent blood clots, and target other risk-raising problems.

Just remembering to take all the pills can be tough, and getting multiple prescriptions refilled is a hassle. That's especially true for older people taking several different medicines for several different health problems.

No wonder experts are constantly wringing their hands over "noncompliance" _ patients not taking the prescription drugs the doctor prescribes.

Taking pills to prevent heart attacks and stroke could get simpler if British scientists succeed with their idea for the "Polypill." It's a single daily pill that contains five drugs and a vitamin for reducing heart disease risk.

Doctors N.J. Wald and M.R. Law have done more than float a trial balloon for the multipurpose heart pill at conferences and in medical publications such as British Medical Journal. They're patenting the Polypill, which they say could be produced easily and sold inexpensively because the ingredients are generic drugs.

Both are specialists in preventive medicine at the Queen Mary school of medicine in London.

Wald and Law envision the Polypill as a kind of "magic bullet" against heart disease. Doctors could prescribe it for almost everyone with heart and blood vessel disease, and almost everybody else over 55.

If that happened, the Polypill "could largely prevent heart attacks and stroke," Wald and Law state in a June BMJ article. The pill, they calculated, would prevent 88 percent of heart attacks and 80 percent of strokes.

People 55-64 who started taking the Polypill would gain about 20 years of life without a heart attack or stroke, they found. Older people might gain about 10 years.

The Polypill combines a "statin" drug that controls blood cholesterol and has other good effects; aspirin to prevent blood clots; small amounts of three blood pressure medications (a thiazide, a beta-blocker, and an ACE inhibitor); and folic acid. Folic acid is a vitamin that reduces blood levels of homocysteine, a material that increases heart disease risk.

Ward and Law pointed out that some people would be unable to take the Polypill. Individuals with asthma, for instance, should not take beta-blockers. Some people can't take aspirin.

But their study found that the six-ingredient combination would be safe for most people, with aspirin likely causing the most serious side effects (stomach bleeding).

Clinical trials will be the reality check, and the researchers hope to move ahead and test the Polypill in big groups of volunteers.