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Yet another new medical wonder, the so-called “magic bullet” or polypill for lower blood pressure and cholesterol, is making quite a buzz in the media. Backers claim it could “slash the rate of deaths from heart attack or stroke” by at least 50% or even, according to some sources, by 80% or more.

The polypill gets its name by combining low doses of 5 different drugs: aspirin for its anti-clotting properties, statins to reduce cholesterol and three different medications for lower blood pressure. It’s been developed primarily for protection against heart disease as high blood pressure and high cholesterol levels are major risk factors for the condition.

Proponents of the drug call for it to be prescribed to everyone over the age of 55, some 75 million people in the United States alone. Some go even further and urge it to be used by everyone from the age of thirty. Nicholas Wald, a researcher at the Wolfson Institute of Preventive Medicine in London says: "there's probably no other preventative measure which would have greater impact on public health in the Western world".

Really? While the polypill approach may sound promising, it is misguided and could actually do more harm than good. Doctors and other experts have long insisted that the most effective protection against heart disease is a healthy lifestyle, a notion that’s become firmly embedded in our consciousness if not always in reality.

But wide-scale use of a polypill could risk undoing this by fooling people into thinking it provides some kind of safety net. "Doctors must ensure that a single pill doesn't lead people to abandon lifestyle choices, such as a healthy diet and regular exercise, which really benefit the heart," says Dr. Christopher Cannon, a cardiologist at Harvard Medical School.

Exercising on blood pressure medication

Dr. Robert Bonow, a professor of medicine at Chicago’s Northwestern University puts it more succinctly: “We already have a polypill – it’s called exercise.”

And the risk to healthy lifestyles posed by the polypill is not just motivational: one of the “magic bullet’s” ingredients is atenolol, a blood pressure drug whose well-known side effects include fatigue, dizziness and short windedness! People taking atenolol describe attempts to exercise on the drug as “trying to swim through molasses”. So in terms of lifestyle the polypill is counter-productive. Some magic bullet… a dud is more like it!

We should also be extremely skeptical about grandiose claims of effectiveness. There is no real evidence whatsoever to support claims that the polypill can cut heart attacks and strokes by 50% or more. The data simply does not exist. Instead, the figures are obtained by manipulating complex probability formulas, which are often not borne out by long-term experience.

Drug companies use the same techniques to predict the incidence of side effects, but in this case with the opposite bias! Side effects are notoriously minimized and you can see this in action in the polypill as well. The safety of statins for instance, a major polypill component, is hotly contested, yet press reports paint only a rosy picture of a medication “well-tolerated”. No mention of atenolol side effects either, effects serious enough for the drug to have been withdrawn for the treatment of hypertension in many countries including the U.K.

Other side effects of polypill components include dizziness, persistent dry cough, muscle cramps and pain, erectile dysfunction, nausea, diarrhea, anxiety and memory loss. Many of these symptoms are infrequent, but what level of risk is acceptable to a healthy person? Every drug has risks and side effects; five of them together introduce complications that are as potentially dangerous as they are unpredictable.

Fortunately, not all doctors are equally impressed by the polypill and some even question its purpose. People at risk of or already suffering specific conditions often need higher doses of one or two specifically targeted drugs, rather than a low dose scattershot of several. And many people are intolerant of or resistant to one or another of the polypill medications. “Drugs need to be tailored to the individual needs of the patient,” says Dr. Bonow.

Worst of all, the polypill is yet another step in a relentless pursuit to medicalize vast numbers of healthy people. This insidious trend is illustrated by the healthy and confident, middle-aged man or woman who comes out of their annual checkup a scared patient with a sack full of unnecessary prescriptions.

Let’s hope that both doctors and patients alike resist this latest attempt to snare millions of healthy people in the drugs trap.

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