A polypill for cardiovascular disease

WELLINGTON – 4 September 2009

A polypill for cardiovascular disease - Panacea or pharmacological nightmare?

Cardiovascular disease is our leading cause of hospitalisation and premature death. Could a polypill be an integral part of the solution to managing cardiovascular risk?

Two senior General Practice specialists debate this issue in the latest edition of the Journal of Primary Health Care (JPHC).

“Yes”, says Dr Raina Elley, pointing out that although cardiovascular risk can be halved by taking ‘triple therapy’ (regular low-dose aspirin, lipid lowering medication and blood pressure lowering medication) 90% of people at high risk and 50% of people with existing cardiovascular disease are not on it. “A polypill should make indicated medications easier to prescribe, easier to accept, and easier (and cheaper) to take, hence improving adherence, avoiding cardiovascular events and lowering the burden of cardiovascular disease in New Zealand.”

“No”, says Professor Les Toop: “The polypill is a natural extension of the current obsession with absolute risk, which, in its guideline and soon to be performance indicator form, takes no consideration of the normal processes of ageing.” Professor Toop asks whether a polypill might not be seen as a panacea –“‘Eat, drink and be merry for tomorrow we have the polypill’ perhaps?”

“There are areas of uncertainty, ethics, and aspects of care for which there is no one right answer,” says journal editor Felicity Goodyear-Smith. “The journal aims to stimulate debate, and managing cardiovascular risk a hugely important component of modern primary care.”

A new Cardiovascular Guidelines Handbook will be promoted to primary care staff at the College’s annual conference in Wellington next week and delegates will be able to have their own heart check.

The Journal of Primary Health Care (JPHC) is the scientific journal of the Royal New Zealand College of General Practitioners.

ENDS

© Scoop Media