by Ross Walker
For a number of years, many experts in the cardiology world have been spruiking the potential benefits of a 'cure-all' poly pill with multiple cardiac medications in the one pill.
One piece of madness from a few years back was the suggestion that everyone over the age of 55 should start popping this poly pill containing a standard dose of a soluble statin, Simvastatin, three half-strength blood pressure pills and low dose Aspirin.
At the time, I expressed enormous concerns about this ‘one size fits all approach’ because of the significant potential for side effects and the important points that when given to everyone over a certain age, it would only benefit less than half those taking it for the obvious reason that less than half the population are affected by clinical cardiovascular disease. Secondly, especially if this was available over the counter, the medical supervision in monitoring for benefits and complications would not be adequate.
Recently, however, two studies were presented at the European Society of Cardiology entitled ‘Focus One’ and ‘Focus Two’ looking at the potential use of a poly pill for people with existing heart disease, ie. heart attack survivors. Focus One looked at medication compliance in 118 heart attack survivors in five different countries showing disturbingly that only 45 per cent were taking their medications correctly, ie. just under half were being adequately treated after heart attack. This was most striking in people below the age of 50, those on greater than 10 pills per day, smokers and those with sedentary lifestyles.
Focus Two was a randomised control trial with just under 700 patients after a heart attack which ran for nine months comparing a fixed dose poly pill containing Aspirin 100mg, Simvastatin 40mg (a fat soluble statin) and Ramipril, a blood pressure pill in varying doses between 2.5mg to 10mg a day depending on the blood pressure. This fixed dose regimen was compared with people taking three separate pills. The study showed much better compliance in people taking the poly pill.
The important message, in my opinion, is the importance of focusing on lifelong prevention whether you have had a heart attack or not. But it is vitally important for all of us to realise that the greatest risk for heart disease is having already had heart disease. What I mean by this is, if you have already had a heart attack, a coronary artery bypass or a coronary stent, then you are at a much greater risk for another cardiac episode than someone who has never had the problem in the first place.
Although a poly pill may be part of the lifelong preventative program for patients with existing heart problems, the five Walkerisms –
– are basically somewhere between two to three times more powerful than taking any medications at all. So as far as I am concerned combining these five key lifestyle principles with appropriate medications and supplements is the key to prevention of any further cardiac issues.
Albert Einstein once said that “nothing is a more certain sign of insanity than to do the same thing over and over again and expect a different result”. It is vitally important to change your lifestyle and attitude to medications, especially if you have already suffered a heart problem.
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