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Heart Disease Super Pill Proposed

A single pill combining six heart medications could avert more than 80 percent of heart attacks and strokes if heart patients and everyone over 55 took it, British scientists said Thursday.

However, the American Heart Association questioned the concept, outlined Thursday on the Web site of the British Medical Journal.

Such a pill could be too dangerous for healthy people, not strong enough for some with heart trouble and may encourage people to maintain their bad habits in the belief that a pill will save them, the American Heart Association said.

"There are massive caveats. We are quite concerned about this," said association president Dr. Robert Bonow.

The idea was proposed by Dr. Nicholas Wald and Dr. Malcolm Law of the University of London.

The pill, which they call the "polypill," would contain aspirin, a cholesterol lowering drug, three blood pressure lowering drugs at half the standard dose, and folic acid.

The components would reduce one of the four cardiovascular risk factors — cholesterol, blood pressure, homcysteine levels and stickiness of the blood.

Based on evidence from more than 750 existing studies involving 400,000 participants taking heart medications, the scientists estimate that if taken by people over 55, as well as many people with high blood pressure, heart disease or diabetes, the pill would prevent about 88 percent of heart attacks and 80 percent of strokes.

They reached those estimates by multiplying together the risk reductions seen in published research on the individual drugs.

Wald and Law calculated that the greatest gain would be from cholesterol drugs, which would prevent three-fifths of the potential attacks.

They calculated that one-third of the over-55s taking the pill would benefit, gaining on average about 11 years of life free from a heart attack or stroke.

However, Bonow from the American Heart Association urged caution.

"There are data already on aspirin that if you give aspirin to a general population, you do not save lives because the people you save by preventing heart disease and stroke is offset by the number of people you kill by causing bleeding," he said.

"In a high-risk population, the lives saved outweigh the risk of bleeding, but not in low-risk people."

While the risk of a heart attack or stroke increases after the age of 55, age alone is not a strong enough risk factor to warrant treatment, he said.

"My concern is one pill may not fit all," he said.

Studies of the "Polypill" are planned to see if the combination is safe and effective. Results are not expected for a few years. Law and Wald have filed a patent application on the formulation of the combined pill they described.

By Emma Ross

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