If you don’t get it right the first time, then you have a golden opportunity to get it really wrong on the second try.
More than five years ago I first told you about the polypill – four-drugs-in-one designed to prevent heart disease. Back in 2003 the polypill only existed as the dream of a miracle drug that mainstream doctors might automatically recommend to everyone who smoked, or was overweight, or was past the age of 55, or was otherwise deemed to be at risk of heart disease.
Great idea! Did it have problems? Sure! Tons of ’em! But it was such a fantastic idea that the problems would surely melt away when the rate of heart disease fatalities dropped dramatically. A miracle!
Well, you know how it is with miracles. You better read the fine print.
According to a recent issue of the UK’s The Guardian, the once-a-day polypill “has been the dream of doctors for many years.”
And a sweet dream it is. Does your patient have high cholesterol AND high blood pressure? Then quick – get out your pad, whip up a polypill prescription and send him on his way with a promise of freedom from heart woes.
The original polypill was planned to combine a cholesterol-lowering statin, an ACE inhibitor, a low dose of aspirin, and folic acid – a synthetic B vitamin that reduces homocysteine levels. The inclusion of this last item in the gang of four was a genuinely good call. But the 2008 version of the polypill has dropped folic acid and replaced it with thiazide – a diuretic that treats high blood pressure.
So…they got rid of a vitamin and added another drug. Now what could possibly go wrong with THAT decision?
The UK team that’s been working and reworking the polypill (now dubbed Red Heart) has started recruiting for the first clinical trial, which will involve about 700 subjects. If all goes well, a much larger trial is planned.
If all goes well? That could be wishful thinking in the extreme.
Let’s look at just a few of the known side effects of the four polypill components, according to information from WebMD.
- Statins: kidney and liver damage, muscle pain, joint pain, weakness
- ACE inhibitors: persistent cough, dizziness, skin rash, swelling of face and throat
- Aspirin: stomach and intestinal bleeding, ringing in the ears, nausea, dizziness
In 2005, one heart doctor noted that when the benefits of the polypill are weighed against the side effects, the widespread use of the medicaiton wouldn’t lessen the load on the public health system. And that was BEFORE thiazide was added!
Thiazide’s potential side effects include frequent urination, erectile dysfunction, worsening of diabetes symptoms, increased triglyceride levels, and decreased potassium.
What’s wrong, wrong, WRONG with this picture? High triglycerides increase heart disease risk, and potassium is a key component of normal heart function.
So the ALL NEW polypill really is a miracle. It’ll be a miracle if you survive it.
“Tests Start on Pill That Could Lengthen Millions of Lives” Sarah Boseley, The Guardian, 9/29/08, guardian.co.uk