Combined heart pills 'doing more harm than good'
GIVING patients a combined pill containing statins, aspirin and drugs that lower blood pressure to everybody over 55 to protect against heart attacks and strokes would do more harm than good and be a waste of money, a leading doctor said yesterday.
The side effects of giving combined pills to millions of people outweighed potential benefits, it was warned.
Allen Taylor, a professor of medicine at Georgetown University in Washington, recommended instead that those at higher risk of coronary disease should be given a computerised tomography (CT) scan.
Plans to give polypills to everybody over a set age have been discussed for more than 15 years and are now beginning to be used in countries such as India.
About 330 Irish people are currently taking a polypill as part of a medical trial being conducted across Europe and through the Royal College of Surgeons here.
Trial
The two-year trial, which will end next year, invited 330 Irish patients to take a 'Read Heart Pill' including low dose aspirin, a cholesterol lowering statin, and two blood-pressure reducing medicines.
Professor Alice Stanton, of the Royal College of Surgeons, the leading investigator of the trial, has said that, if successful, the polypill would help combat the problem of patients on several medications who either neglected or forgot to take all their tablets daily.
"Many people on long-term medication are not taking it properly. It means that blood pressure and cholesterol are silently doing more and more damage," she warned.
Advocates say the pills are necessary because only one in five heart disease patients remember to take multiple pills daily, and the cost of distributing them separately is too high, particularly in poorer countries.
But Prof Taylor said the argument that polypills caused few side effects was "baloney". He said a much more targeted approach was needed.
Recent data showed CT scans for arterial calcium could be extremely useful in gauging the risk of a cardiovascular event, he said.
Those who had no such build-up had just a one in 1,000 chance per year of having one. This could screen out those who would be unlikely to benefit from drugs.
Essential
Prof Taylor highlighted his concerns at the European Society of Cardiology in Paris. One of the polypill's leading proponents, Prof Salim Yusuf of McMaster University in Canada, had told the conference that the polypill was essential to help combat "the biggest epidemic society in its history has ever faced".
Attempts focused on lifestyles had failed, he said. "Instead of saying 'lifestyle first and drugs next', why don't we say drugs is the basis?"
Prof Taylor described the strategy as a "waste of money". "It's not that these pills are ineffective, but we risk over-treating people," he said.
At the age of 40, someone has between a one-in-three and a one-in-two lifetime risk of developing cardiovascular disease, he said. (© Daily Telegraph, London)
- Stephen Adams in London
Irish Independent
