Daily Archives: 5 September, 2012

Will the polypill be effective

A new study assessing the benefits of taking the polypill – a medication intended to ward off heart disease – suggests that it could potentially prevent thousands of heart attacks and strokes. However, the study’s results, which generated a lot of headlines when it first appeared, are not as clear-cut as they might seem. Researchers from Queen Mary, University of London looked at the effects of taking the polypill for individuals aged over 50, none of whom had a history of heart disease.

This was a cross-over trial, meaning that all the participants took the polypill and a placebo but during different time periods. Each participant had three months on the polypill and three months on the placebo; some took the polypill first, others the placebo. This method allowed the researchers to assess the benefits for each individual – comparing an individual’s physical response to the polypill to their response to the placebo – rather than one group against another, which provides greater accuracy.

The polypill used for this study works on different levels: it targets blood pressure with three different medications, and also contains a statin to lower cholesterol. With high blood pressure and high levels of LDL cholesterol being precursors to heart disease, a reduction in these areas should also significantly reduce the likelihood of heart disease.

The human heart

The human heart

And the researchers found that taking the polypill resulted in a 12% reduction in blood pressure and a 39% lower LDL cholesterol level. These are the equivalent levels, on average, of a person around 30 years younger than the study participants. This, say the researchers, indicates that the incidence of heart attacks in the over 50s could be avoided or delayed by as much as 28%, if they were taking the polypill.


It would seem sensible then, to offer this polypill to everyone over the age of 50. But the results shouldn’t be interpreted so quickly or easily. The study, which was funded in part by the pharmaceutical company Cipla, was co-authored by the same individual who holds the patent for the pill. The study looked at only 84 individuals – an aspect of the study many newspapers failed to report on – and so extrapolating from the study results that the pill could help prevent thousands of deaths is premature, say spokespeople from the NHS.

Furthermore, the study did not take into account – or analyse – potential side effects from taking the medication. Large-scale studies and, importantly, long-term studies need to be undertaken so that the polypill’s benefits can be fully understood and decisions can be made as to whether it should be made available to everyone. In the meantime, the best advice you can follow is to live as healthily as possible – a diet rich in fresh vegetables, fruit and wholegrains, plus regular exercise is by far the best way to prevent heart disease.

PSA test for prostate cancer saves lives

A controversial blood test for prostate cancer may have significantly improved the survival prospects of patients diagnosed with advanced disease, research has shown.

Scientists identified a reduced risk of dying of almost a third since the widespread introduction of the PSA (prostate specific antigen) test in the late 1980s and early 1990s.

The PSA test identifies a protein in the blood that can signify the presence of prostate cancer.

Critics say the test is too unreliable to be used for routine screening, which is why there is no automatic PSA testing in the UK.

Instead, it is used on a case by case basis with men who exhibit symptoms.

But the new American study suggests that widespread PSA testing can save lives.

The test is used more often in the US than the UK, though the American Cancer Society no longer recommends it for routine screening.

Scientists studied survival data from prostate cancer trials conducted before and after PSA testing was introduced in 1987.

The prostate

The prostate

In the two earlier trials, which enrolled patients between 1985 and 1994, typical patient survival was 30 and 33 months.

By the time the later trial was conducted, between 1995 and 2009, survival had increased to 49 months.

The risk of death had reduced by around 30%.

All the patients had newly diagnosed advanced cancer that had spread to the bones and were receiving hormone deprivation therapy.


Between the earlier and later trials the survival gap between African American and Caucasian men with prostate cancer narrowed.

African American survival rose from 27 months to 48 months.

Men of African descent are more likely to be diagnosed with aggressive prostate cancer than white men.

Study leader Professor Ian Thompson, from the University of Texas at San Antonio, said: ‘Our analysis indicates an overall improvement in risk adjusted survival rates for non-African American and African American men.

‘Of note is the resolution of disparity in survival between the races found in earlier studies.

‘While not all of these welcome improvements can be attributed strictly to PSA testing, without a doubt it has played a role in extending many lives.’

The research is published in the Journal of Urology.

Previous studies have suggested that PSA testing saves few lives and in many cases can lead to risky and unnecessary treatments.