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The Poly Pill – Can Scientists Successfully Imitate Nature?

Note: this content originally appeared in our November 2005 newsletter. More up-to-date research may be available, but the message is still the same!

The newest creation to save humanity from itself is the polypill, designed to treat the ravages of widespread gluttony. In a recent issue of the British Medical Journal, researchers claimed a combination of popular medications into one pill could slash the rate of deaths from heart attack or stroke by over 80 percent—designed for people eating a high-fat, Western-type diet and practicing a destructive lifestyle.1  Because of the potential benefits, the polypill has been recommended for all people over 55 years old—and plans are to sell this wonder-cure without a prescription (over-the-counter) for a little more than $1 per daily dose.  The present prototype for the polypill would contain a cocktail of six existing drugs known to treat the four key risk factors for heart disease and stroke—high cholesterol, elevated blood pressure and homocysteine blood levels, and increased blood clotting.  (This is not a joke, but a serious recommendation by the scientific-medical community for helping with our current health crisis.)

 

  Heart Attack Prevention Polypill

Lipitor 10 mg

Hydrochlorathiazide

Lisinopril

Atenolol

Folic Acid (0.8 mg)

Aspirin (75 mg)

 

 

One of the polypill’s inventors, Nicholas Wald of the Wolfson Institute of Preventative Medicine in London, said, “It is a complementary measure. Indeed, if we all had the right diet from the day we were born, it would not be needed. But changing the diet of an entire nation is impractical.”2 He is right; historically, for most people, taking drugs has been far more popular than eating vegetables. And a pill might be a reasonable alternative if it worked; but, the truth is, no amount of medication will compensate for the ravages caused by the rich Western diet.

 

 

Nearly Everyone’s Sick

There is no question that there is a need for some medical miracle, since most people living in modern societies are fat and sick. For example, look at America:

  • Most people older than 35 years have one or more risk factors which predict they will suffer a tragedy, like a heart attack

  • More than one-third of them have high cholesterol

  • More than one-third have high blood pressure

  • Nearly two-thirds are too fat for their own good and more than 30% are frankly obese

  • Nearly 10% have diabetes

  • One-fifth of adult Americans smoke and most have inactive lifestyles

All these predictions of disease translate into the fact that every year 1.2 million Americans will have a heart attack and about 700,000 will have a stroke.3

 

The Poly-pill Replaces Poly-pharmacy

 

Noon-time educational conferences at hospitals are sponsored by drug companies—they pay for the lunch and the speaker—a small price for a doctor’s mind.  I learned about the “proper care” of a person with type-2 diabetes at one of these weekly promotional events.  By the end of an hour-long presentation most of the physicians in attendance were thoroughly convinced that the optimal way to treat someone with diabetes was to prescribe 20 different kinds of medications. A feeling of importance was given to this multidrug approach by introducing a new and high-tech-sounding term to describe this manner of practice: poly-pharmacology. Yes, a “competent” physician was going to be putting his sick patients on a regime of poly-pharmacy.  

 

The polypill is simply a more convenient way to practice poly-pharmacology—rather than taking pills from many bottles each day, one pill contains all the separate medications.  However, widespread use of the polypill is unlikely because it would mean a serious loss of profits for the drug industries.  As Dr. Wald puts it, “Pharmaceutical companies need to make money and the concept of the polypill for some will erode their existing market.”2

 

 

The Poly-pharmacology for the “Well-treated” Patient

Pills prescribed for these common dietary-caused conditions—one patient will typically be taking many of these:

Blood pressure: ACE inhibitor (Zestril); beta blocker (Tenormin); calcium channel blocker (Cardizem)

Blood sugar: sulfonylurea (Glucotrol); metformin (Glucophage); Pioglitazone (Actos)

Cholesterol: atorvastatin (Lipitor); ezetimibe (Zetia)

Uric acid: allopurinol (Zyloprim)

Homocysteine: folic acid (Foltx)

Triglycerides: gemfibrozil (Lopid)

Hypercoagulability: clopidogrel (Plavix) (aspirin is too inexpensive)

Indigestion: esomeprazole (Nexium)

Anxiety: alprazolam (Xanax)

Insomnia: zolpidem (Ambien)

Body fat: orlistat (Xenical)

Headaches: propoxyphene (Darvocet)

Body aches: ibuprofen (Motrin)

Constipation: an osmotic agent (MiraLax)

Diarrhea: a narcotic agent (Lomotil)

Body odor: deodorants and perfumes to disguise the animal food-derived odors

 

Accept the Obvious Pill?

 

People love the easy way out and the population-curing polypill could be a license for some people to follow an unhealthy diet and lead unhealthy lifestyles—if it worked as advertised—but it doesn’t.  The pill that works is two to five pounds of low-fat, plant-based foods daily and a pair of walking shoes.  Besides, taking pills is one more bothersome addition to a person’s already busy daily routine and is an unnatural behavior—people must eat as a normal part of their lives—so the most practical way to real population-cure is simply a substitution of the rich Western diet for the McDougall Diet.

 

References:

1)  Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ. 2003 Jun 28;326(7404):1419.

2) Wald quotes:  http://www.guardian.co.uk/uk_news/story/0,,985670,00.html

3) Mulrow C, Kussmaul W. The middle-aged and older American: wrong prototype for a preventive polypill? Ann Intern Med. 2005 Mar 15;142(6):467-8.

4) Trewby P, Trewby C.Polypill” to fight cardiovascular disease: patients before populations. BMJ. 2003 Oct 4;327(7418):807;

5) McDougall Newsletters addressing the limitations of antihypertensive medications, aspirin and folic acid:
July 2004: Over-treat Your Blood Pressure and You Could Die Sooner
July 2005: Neither Aspirin Nor Vitamin E Will Save Women
October 2005:  Folic Acid Supplements are a Health Hazard 

6) Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R; Cholesterol Treatment Trialists’ (CTT) Collaborators.Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005 Oct 8;366(9493):1267-78.

7)  Messori A, Santarlasci B, Trippoli S, Vaiani M. Questionable cost-effectiveness of statins for primary prevention of cardiovascular events [electronic response to Wald et al]. bmj.com 2003. bmj.com/cgi/eletters/326/7404/1407#34612