A four-in-one daily “polypill” containing a statin and three blood pressure lowering drugs should be offered to all over 50s, experts have said. Academics from University College London (UCL) said a mass prescribing programme could replace the NHS Health Check, which sees people aged 40 to 74 offered tests every five years to identify those at risk of heart disease, stroke, and other conditions. They estimated that if just 8% of over 50s started taking the polypill, this would achieve greater health benefits than the NHS scheme.
Polypills combine multiple drugs in a single tablet. Research suggests they can be more effective as patients are more likely to stick to their treatment regime if it involves one pill rather than several medications. Study co-author Professor Aroon Hingorani, of the UCL Institute of Health Informatics, said: “The NHS Health Check isn’t working very well.
“Uptake is low, with only four in 10 people taking up the offer of an appointment. Lots of people who would benefit from medication are not prescribed it.
“What is more, our complex risk prediction tools are not very effective. They do not predict very well who will get a heart attack or stroke. That is because most heart attacks and strokes occur in people with average levels of risk.
“Now is the time to do much better on prevention. A population-wide approach could prevent many more heart attacks and strokes than the current strategy of targeting a more limited group only.”
Writing in The BMJ, Prof Hingorani and his colleagues argued that a polypill programme could be a “flagship strategy” for Labour’s goals of preventing disease rather than treating its consequences.
They pointed to a landmark 2003 paper which estimated that giving all over 55s a polypill containing aspirin, folic acid and drugs to lower blood pressure and cholesterol could prevent 80% of heart attacks and strokes.
Meanwhile, a 2019 trial in rural Iran found that a polypill taken for five years reduced heart attacks and strokes by a third.
Prof Hingorani added: “A polypill programme would be a simple, effective, and potentially low-cost strategy. The drugs are off patent so inexpensive.
“Many years of evidence show statins are low risk, with minimal side effects, while combining three blood pressure lowering drugs at low dose reduces these drugs’ side effects and increases their benefits.
“People could receive an offer of a polypill once they turn 50. They would not need a health check or test but only to answer a few questions to assess their risk of side effects.
“Further assessments via an online questionnaire could be required before the prescription is repeated.”
