The Polypill: One Size Does Not Fit All
A recent study published in the medical journal, The Lancet, follows the results of a large scale clinical trial on an experimental new medication called the “polypill.” This medication combines three types of blood pressure lowering agents, a cholesterol lowering statin drug and low dose aspirin. The theory is that combining these drugs will create a greater overall effect in reducing cardiovascular risk than taking any of the single drugs by themselves. Another goal of the polypill is to create an easy, inexpensive way for people to get all their cardiovascular related medication in a convenient one time dose.
Conceptually it does not sound like a terrible idea. Why take five pills when you only have to take one? It makes compliance easier and reduces medication cost, a winning combination of factors for many people.
In my opinion, the problem lies in the basic thinking that more pharmacy is better. It also does not take into account the implications of combining such a variety of medications. Understanding the intricate side effects each medication may create for an individual is almost impossible. Each person’s body is its own unique mixture of genetic and biochemical variations. This is why one person may not be able to tolerate a certain medication while another has no side effects whatsoever. We already know that the incidence of serious injuries and deaths associated with medications is on the rise and becoming a major epidemic in our country. Introducing a polypill further complicates the picture of drug interaction and increases potential for adverse events.
To complicate matters further, the individuals that are most likely to be a candidate for the polypill are those that already have significant risk factors for other diseases like obesity and diabetes. This makes it much more likely that additional medications will be needed to manage the other aspects of their health, adding more pharmaceutical variables to the equation and further increasing the risk of adverse drug interactions.
Another targeted population for the polypill would no doubt be the elderly, due to the reduced cost of the combined therapy. However, the risk of having a serious adverse reaction to a drug significantly increases with age due to a decrease in our body’s ability to metabolize medication and due to a greater ratio of fat tissue to muscle mass. This puts older individuals at a greater risk for injury from combining multiple medications. Additionally, they also fall under the category of individuals likely to be on other medications.
The decision to use pharmaceutical therapy should be heavily considered for each individual. Using the least amount of medication in the lowest doses necessary to create the desired clinical outcome should be of the utmost importance. The medical establishment has become far too eager to prescribe medications for any situation without considering the potential negative effects that medication might have on a person. As a society completely dependant on pharmaceutical intervention to manage our health conditions, we are just as guilty as the doctors for an increase in pharmaceutical use. Not enough emphasis is placed on lifestyle changes as a viable mechanism to address the major health issues facing our country. Doctors happily use the prescription pad to fix a problem, often due to the fact that they only have 5 – 10 minutes to assess the person’s situation and provide an intervention that will prevent that person from being at risk of a more serious complication related to their problem.
This polypill is the ultimate example of how pill dependent Western society has become when it comes to addressing our health needs. I believe it also poses a significant risk due to the fact that more people would be receiving polypharmacy (taking multiple drugs at one time), which increases the chances of having an adverse drug reaction. As a country we need to continue to focus on improving health using the least amount of medication possible and by maximizing a person’s ability to take control of their health issues with safer interventions such as diet, exercise and natural therapies. A major shift would need to occur in our health system to make this possible. Insurance companies only reimburse for services related to drug therapy or surgery. Very few insurance companies will pay for detailed nutritional counseling, exercise programs and access to complementary and alternative practitioners. Until these therapies are taken seriously by the public, the medical community and the insurance companies we will continue to see a rise in the use the pharmaceuticals. We will also likely continue to see a decline in the overall health of our country.
Luckily, the polypill is only in the beginning phases of clinical trials and has not been tested in the U.S. The FDA has very strict regulations regarding pharmaceuticals that combine several different medications. In fact, FDA rules and regulations would have to be amended for the polypill to be allowed in the U.S. because there is no way to fully understand how these different medications will interact with each other.
The Anti-Aging Bottom Line: A drug that combines multiple medications to target risk factors for heart disease may sound like a great idea to some. However, the recent surge in the number of drug related deaths is evidence that in the case of powerful and potentially harmful pharmaceutical drugs, more is certainly not better. The holes in the theory behind the polypill reflect larger holes in our society’s current pharmaceutical-laden medical model. The rates of heart disease, obesity and diabetes are nearing epidemic proportions in the U.S. and now is the time to focus on natural means of reducing your risk for these lifestyle-related conditions.
