I’ll admit it now – I’m seriously concerned. Not because of what my readers might think of me for reading the Daily Express (I was waiting in the bank on 4th September and a particular headline caught my eye, OK?), but in what the general population is being exposed to as a new medical “breakthrough”. The attention-grabber in question was as follows:
“10 pence pill could help you live eight years longer.” So, not being one to shy away from commenting on the latest “wonder drug”, you can bet I wanted to know more. The link to the article in question is below:
So, let me get this straight. If we take a single pill, that contains aspirin, simvastatin, lisinopril and either atenolol or hydrochlorothiazide, one in three of us could go an extra 8 years before succumbing to a heart attack or stroke (I’d like, at this point, to mention that taking a placebo gives a benefit of approximately 1 in 3 for ANY study on ANY drug). For those who don’t have a medical bias, the drug cocktail in this latest magic bullet is as follows: a drug that prevents blood from clotting (but increases the risk of gastric ulceration and internal bleeding), a cholesterol-lowering drug with a whole host of potential adverse effects (see my separate blog, The Dark Side of Statins, here), an ACE inhibitor (drug that lowers blood pressure, but can cause kidney impairment and elevations of blood potassium levels), and a beta-blocker (atenolol), which reduces the rate and contractility of the heart, thereby reducing blood pressure (but can cause a number of adverse effects including vomiting, diarrhoea and kidney damage). If your “wonder pill” contains hydrochlorothiazide rather than atenolol, this lowers your blood pressure by dehydrating you – if you have less fluid in your blood vessels (dehydration causes this) then by simple physics the blood pressure will be lower. However, hydrochlorothiazide increases the risk of diabetes, and also raises blood cholesterol. Fortunately though, you’ll see that the statin included in the mix reduces cholesterol, so you’ll be fine…
Not so, in my opinion. Look up the side effects of all these drugs individually, and you will see that there are plenty of potential downsides. In the case of hydrochlorothiazide, look up the side effects and you probably won’t want to go near the stuff! Once we get into the concept of “polypharmacy” – taking lots of different drugs at the same time – we can get into all sorts of trouble. For example, this pill contains aspirin, which is known to be contraindicated if you are also taking ACE inhibitors (this is dose-dependent). Add in the other drugs, and seriously, who knows what is going to inter-react with what, and what those adverse effects might be? There might indeed be “a pill for that too” (such as giving anti-nausea pills for those that vomit on beta blockers, or anti ulceration drugs for those who don’t tolerate aspirin, but what are we leaving people exposed to here?).
The thing that concerned me most about this “polypill”, however, is not just that the pharmaceutical industry might be pushing doctors to prescribe it for all their patients over the age of 50. No, it is the fact that the article indicated that this medication might be available for “over the counter” sale as early as 2015. That means, basically, that anyone can wander into their local pharmacy and buy it for themselves, without prescription, totally unaware of whether they actually have the kind of problems that might make them “need” to use this approach in the first place. With reference to statins alone, side effects have been played down. In February 2008, the Medicines and Healthcare Products Agency (which, despite being in place to regulate the pharmaceutical industry, is actually funded by them, leading to a huge conflict of interest) raised the issue that a new warning should be put on the label of statins. Evidently, nothing happened for 21 months because one of the drug companies “didn’t agree on the wording”. As a commentator in The Guardian responded: “A drug company has been able to delay the inclusion of safety warnings on a drug prescribed to 4 million people for 21 months because it didn’t agree with the wording. There is no conceivable world in which this is a good thing.”
One of the saddest things prevalent in the mechanistic and drug-dependent world of the science that is modern medicine, is that alternative options never seem to be studied alongside pharmaceutical prescriptions. For example, in other areas of medicine, research has indicated that psychotherapy is a much better alternative to antidepressants, with no side effects and a longer duration of beneficial action. Still, the medical industry continues to ply the unsuspecting and mildly depressed public with pharmaceuticals which may do little better than placebo, but have considerably more adverse effects. My fear is the same with this “polypill” and the proclamation that it will be the answer to our preventative prayers. At best it raises issues of concern with drug interactions – at worst, people in low-risk groups who decide to self-medicate could be in for side-effect hell and even risk their lives. And all for something that only delays a heart attack in 30% of people, doing nothing to prevent one.
What, then, is my alternative suggestion? Embrace the real, and very achievable, concept of prevention. Eat a plant-based, unprocessed, and wherever possible uncooked, antioxidant-rich diet. Avoid toxic habits such as smoking and junk food consumption. Take whole-food derived supplements. Exercise on most days. Get sufficient rest. Cultivate a good supportive social network and a positive attitude. Hang out with happy people. Then, as well as preventing heart attacks and stroke, you’ll also slash your cancer risk, weigh less, eliminate bad cholesterol, feel healthier and look sexier. Now tell me, what pill can do that?