A new study soon to be published in the print European Journal of Epidemiology, shows that substantial health benefits would be gained if people aged 50 and over were invited to join a Polypill Prevention Programme to significantly reduce the risk of having a heart attack or stroke.
Following medical review, those eligible to participate in a Polypill Prevention Programme, which is already available outside the NHS (polypill.com), would take one pill a day for the rest of their lives. As a result one in three would directly benefit and gain, on average, eight years of life without a heart attack or stroke.
Primary prevention of cardiovascular disease is a public health priority. While the NHS recognises this in promoting its Health Checks Programme, a Polypill Prevention Programme has many advantages. It is simpler and focuses on the preventive intervention rather than the identification of risk factors. An inexpensive and effective screening policy based on a person’s age alone can be used to identify increased risk; it is no longer necessary to use cholesterol and blood pressure testing as well because there is a benefit in lowering these levels even if they are not considered high.
“Age is the single strongest predictor of a future heart attack or stroke in people who have not already had one”, says lead author of the study, Professor Sir Nicholas Wald, Professor of Environmental & Preventive Medicine of The Wolfson Institute of Preventive Medicine at Queen Mary University of London.
“A Polypill Prevention Programme would be a better public health activity than the current (“MOT”) Health Checks which cost the NHS £450m (2015) each year, excluding any costs of preventive treatment. The advantage of a Polypill Prevention Programme is that most of the costs are incurred in delivering the preventive treatment.”
Savings of £2.65billion arising from the disease prevented would be offset by the cost of a Polypill Prevention Programme. There would be a net cost of £2.11billion, representing a net cost per year of life gained without a heart attack or stroke of around £2,000 if the cost of providing the programme were £1 per person per day. If the cost of the programme were less than 56p per person per day there would be a net saving.
Cardiovascular disease, particularly heart attacks and strokes, is one of the leading causes of death and disability throughout the world. Whilst it is recognised that the primary prevention of cardiovascular disease is important with recommendations that people should reduce their salt, sugar and saturated fat intake, take regular exercise, control their weight and avoid smoking, it is generally accepted that people at sufficiently high risk of a heart attack or stroke should be identified so that they can receive preventive medication.
The polypill consists of a statin to lower LDL cholesterol and three low dose blood pressure lowering drugs to reduce blood pressure. It has been established, on the basis of epidemiological evidence and from randomised trials, that reducing these risk factors has a substantial impact in reducing the risk of a heart attack or stroke.