The Polypill
Chester J. Zelasko, Ph.D. | August 12, 2003

For the most part, better health is a choice. You can exercise or not. You can eat a good diet or not. You can carry excess body fat or you can lose it. You can smoke cigarettes or not. Your family history (genetics) does have an influence but for most of the degenerative diseases that afflict Westernized countries, the lifestyle people choose determines whether or not they will get the disease. This is especially true for cardiovascular disease (CVD), and more people die from CVD in Western society than from any other disease.

Researchers in Britain have proposed a solution for reducing CVD by more than 80%--a polypill (1). After examining the data in large clinical trials, they determined that four risk factors for CVD are important to control: LDL cholesterol, blood pressure, homocysteine levels, and platelet aggregation (clotting). They proposed that a combination of pharmaceuticals and vitamins could be used to control these risk factors and thereby reduce the morbidity rate 80%. The polypill would include:

  • A statin drug to lower LDL-cholesterol
  • Aspirin to prevent blood clotting
  • Folic acid to reduce homocysteine levels
  • A diuretic, a beta-blocker, and an angiotensin-converting enzyme inhibitor (ACE inhibitor) to lower blood pressure
These medications, combined in a single pill, would be about one-half the normal dose taken to treat disease. Who would take it? Everyone 55 years old and older. That's correct: everyone.

The researchers understood that their view would be controversial--there will be years of clinical trials and debate before this polypill is available. But they also made a statement that goes a long way toward explaining why they took this approach. "It should be recognized that in Western society, the risk factors are high in us all so everyone is at risk." One interpretation of that statement is that people who live in Western society refuse to change their diets, refuse to lose weight, and refuse to exercise--so they must all take medications to lower their risk of disease.

I can't fault the researchers for taking that approach. We have done little in our society to prove that we are willing to change our lifestyles. Each of the risk factors addressed by the researchers can be dealt with through lifestyle changes: exercise, lose weight, lower intake of saturated fat and refined carbohydrate, increase intake of polyunsaturated fat, and supplement the diet with a good multivitamin-multimineral. But they didn't even address the issue of lifestyle change because we haven't been willing to change.

Isn't it time for us to begin to exercise regularly, eat less and eat healthier, and modify other things in our lifestyle as well? If we don't, let me ask this: how long will it be before health insurance carriers tell us that if we don't take the pharmaceutical, we won't get insurance? You don't think it could happen? With the cost of healthcare spiraling out of control, what makes you think they won't insist on this form of prevention?

If this doesn't provide you with the incentive to start adopting a healthy lifestyle, I don't know what will. Your body, your choice--at least for now.


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