Q&A The Polypill (Source:BBC News)

Q&A: The Polypill
Experts are hailing a pill that combines five drugs into one tablet as the magic bullet to heart-related problems.

What is the Polypill?
The polypill contains five drugs that experts believe can halve the risk of strokes and heart attacks in middle-aged people.
It contains aspirin to thin the blood, a statin drug to lower cholesterol levels and three blood pressure-lowering medications - an ACE inhibitor, a beta-blocker and a diuretic.
It also includes folic acid to reduce the level of homocysteine in the blood which is another risk factor for heart disease.
Combining all of the drugs into one easy to take tablet should improve compliance.

What is the big idea?
Doctors want to use the polypill against the worldwide epidemic of cardiovascular disease.
Currently, doctors treat high risk patients but many who would benefit from treatment do not receive it.
The polypill idea is for mass prescription to everyone over a certain age - 50 for men and 60 for women - not just those with pre-existing cardiovascular disease.
By doing this, tens of millions of lives could be saved worldwide, experts believe.
Yet a decade since its first inception, a marketable product is still at least five years away.

Why is it taking so long?
The polypill does not promise big profits for pharmaceutical companies.
Although the tablet would be taken on a daily basis by millions of people, the five constituent medicines are cheap and are already available separately. These are non-patented drugs.

What has the latest study shown?
It is a proof of concept study that shows the constituent drugs can be safety combined and work in the way intended, lowering blood pressure and cholesterol levels.
Reassuringly, few patients had side effects and the pill was well tolerated.
More work is now underway to see if the pill cuts deaths and disease by as much as experts hope.

What do critics say?
Critics are concerned that people will see the polypill as an excuse not to address lifestyle issues, such as poor diet and lack of exercise, linked with cardiovascular disease.
And one size fits all may not work.
Each of the constituent drugs has side effects. By combining them you do not get rid of those risks.
By and large, the benefits far outweigh any risks, but Professor Peter Weissman of the British Heart Foundation said: "If money was no issue I would want to know exactly what my cardiovascular risk is and I would want my doctor to treat each of those risk factors optimally rather than the fire and forget approach that the polypill will produce."

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