Tuesday, March 31, 2009

Future, Prevention - Polypill Arrives Ahead of Schedule

You can’t say I didn’t telI you . One of the great things about writing a daily blog over an extended period of time is that sooner or later, you’re bound to be right.

This, by way of explanation, is my 787th blog dating back to December 2006.

One, on February 6, in a “2020 Blog,” I predicted in 2020 a pill would be developed to prevent many heart attack and stroke deaths.

Here is what I had to say.

One: "The U.S. has virtually ended deaths from heart disease and strokes with a daily poly-pill for everyone over 55. British researchers first described the poly-pill, made up of six medications: a statin, three anti-hypertensive drugs, folic acid, and aspirin.6 This multi-purpose pill reduces cardiovascular disease by controlling LDL cholesterol, blood pressure, homocysteine levels, and platelet function.”

“The poly-pill has extended U.S. life spans by 12 years. Alarmists in 2006 warned poly-pills would harm patients and increase Alzheimer’s cases. Not to worry. The malpractice lawyers have been neutralized, and we now have pills for every side effect, including dementia”

Two: Then on November 21, 2008, in “Start Simple, Think Big, Think Polypill, Think Longevity,” I had this to say.

“Major society-changing innovations are not for the timid or for seeker-of-devils-in-the-details or sludge-in-the-entrails.

“Major innovations begin with 2 steps:

1) Start simple.

2) Think big.

“What could be simpler than taking one pill a day to prevent future vascular disease for humankind? What could be bigger than warding off premature death in millions of people with interrelated metabolic disease?"

"This monumental innovation may not happen, but it’s worth a series of clinical trials, already underway. For the polypill manufactured by Dr. Reddy’a of Hyberabad, India, it’s a case of Reddy, Aim, Fire!”

Well, I’m pleased to say that a March 30, 2009 article “One-a-Day Heart Combo Pill Shows Promise” by the AP from a cardiology meeting in Orlando, Florida, reports the following, and I quote:

“ORLANDO, Fla. – It's been a dream for a decade: a single daily pill combining aspirin, cholesterol medicine and blood pressure drugs — everything people need to prevent heart attacks and strokes in a cheap, generic form. Skeptics said five medicines rolled into a single pill would mean five times more side effects. Some people would get drugs they don't need, while others would get too little. One-size-fits-all would turn out to fit very few, they warned. Now the first big test of the "polypill" has proved them wrong.”

“The experimental combo pill was as effective as nearly all of its components taken alone, with no greater side effects, a major study found. Taking it could cut a person's risk of heart disease and stroke roughly in half, the study concludes.”

“The study tested the Polycap, an experimental combo formulated by Cadila Pharmaceuticals of Ahmedabad, India. It contains low doses of three blood pressure medicines (atenolol, ramipril and the "water pill" thiazide), plus the generic version of the cholesterol-lowering statin drug Zocor, and a baby aspirin (100 milligrams).”

“The study involved about 2,000 people at 50 centers across India, average age 54, with at least one risk factor for heart disease — high blood pressure, high cholesterol, obesity, diabetes or smoking.”

“Four hundred were given the polypill. The rest were placed in eight groups of 200 and given individual components of the pill or various combinations. Treatment lasted 12 weeks.”

Compared to groups given no blood pressure medicines, those who got the polypill lowered their systolic blood pressure (the top number) by more than 7 units and their diastolic (the bottom number) by about 6 — comparable to levels for people who were given the three drugs without aspirin and the cholesterol drug.

“These drops were modest, probably because doses were low and most participants had only moderately high blood pressure to start with, Yusuf said.”

“LDL, or bad cholesterol, dropped 23 percent on the polypill versus 28 percent in those taking the statin drug separately. Triglycerides dropped 10 percent on the combo pill versus 20 percent with individual statin use. Neither pill affected levels of HDL, or good cholesterol.”

“Anti-clotting effects seemed the same with the polypill as with aspirin alone.”

Admittedly, I’m being a little too over self- congratulatory here. The idea for the polypill came not from me, but from two British researchers back in 2003, and a firm owned by a physician from India formulated the pill (1.Wald, NJ, and Law, MR, A Strategy to Reduce Cardiovascular Disease by more than 80%, British Medical Journal, Page 1419, 2003.
2.K.Srinath, “The Preventive Polypill – Much Promise – Insufficient Evidence,” New England Journal of Medicine, Page 212, January 18, 2007).

But as archy the cockroach, the creation of Don Marquis, might say, “whatthehell,,hellsbells, sometimes you have to blog your own horn.”

The Moral

That big innovations have to be complicated,

is a concept that is truly vastly overrated.

Take the heart and stroke prevention polypill,

It fulfills practically every innovation bill,

And it is just what the doctor indicated.

That's teh way I see it.

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