The ‘polydora’ returns: might a tablet be given to all 50 years to forestall cardiovascular ailments? | Health and effectively -being | EUROtoday

According to knowledge from the National Institute of Statistics, multiple in 4 individuals killed in Spain in 2023 did so on account of ailments of the circulatory system, that are charged in complete round 120,000 lives annually. According to an opinion article printed in early March within the prestigious scientific journal The BMJhundreds of these deaths could possibly be prevented. As? Establishing the supply to all residents over 50 – though a lot of them don’t enter what could possibly be thought-about a inhabitants of threat – of a polydora that mixes a statin and three drugs to cut back blood stress.

The authors of the article, three professors of epidemiology and preventive drugs on the University College London and the University of Birmingham, strongly requested to the British well being system the adoption of this measure that, in response to their estimates, with which they solely settle for 8% of the aged 50 already provided a well being profit better than the present management and screening techniques. The researchers held their request based mostly on two arguments. On the one hand, that complicated threat prediction instruments should not efficient and could possibly be leaving many potential victims out. “Most infarctions and stroke occur in people with average risk levels,” they level out. On the opposite, which is a “simple, effective and economical” technique, for the reason that drugs that the polypíldora embrace not patent and have minimal unintended effects.

“More than one Medicalization From a wide sector of the population, a polydora program is a preventive strategy designed to prevent a person from becoming a patient. It can be compared to public health programs such as vaccination, salt reduction in food and the addition of folic acid into the flour, ”says one of many authors, Nicholas Wald, which already in 2003 started to review the effectiveness of the polypíldora as a major preventive software.

Cardiologist Valentín Fuster is director of the National Center for Cardiovascular Research Carlos III (CNIC) in Madrid and one of many world’s best specialists within the space of ​​Cardiovascular Preventive Medicine. And he explains: “I believe in the concept of Wald and you have to congratulate. Implant a polydora to prevent the disease “is absurd”: “But it is the reality of the world in which we live.

His opinion is shared by Armando Oterino, a member of the Association of Preventive Cardiology of the Spanish Society of Cardiology (SEC), which considers that the base, before the establishment of the polypíldora or of any other pharmacological therapy, should go through controlling the risk factors with hygienic-dietary measures (physical exercise, Mediterranean diet, quitting smoking…). Base, not by the roof.

To this, the cardiologist of the San Pedro de Alcántara Hospital in Cáceres adds the importance of correctly identifying the risk factors of all patients. “Control triglycerides and LDL cholesterol, control tension, tobacco, all that are risk factors.

Polypildora yes for patients with a history

In 2022, Dr. Valentín Fuster’s team published in New England Journal of Medicine A study that concluded that a polyps that includes aspirin, atorvastatin and Ramipril could constitute a simple approach to secondary prevention and complications after a myocardial infarction. According to the results of the study, this polyps designed by the Fuster itself, reduced cardiovascular deaths in infarcted patients, fundamentally thanks to the improvement of the adhesion of patients, something essential after suffering an acute myocardial infarction, since the increase in adherence implies a longer treatment and, therefore, a lower risk of suffering cardiovascular events. In the end, as Armando Oterino adds, it is easier to get a patient to take a pill, take three. In fact, according to the expert, adherence figures to statins, reference drugs to keep cholesterol under control, barely reach 50%.

Today the Fuster and CNIC polydora has already been approved by the European Medicines Agency (EMA), is available in 30 countries and is trying to get the approval of the FDA, the US Medication Agency. Not only that, in 2023 the World Health Organization included it in its list of essential medicines, where the drugs that every health system must have available. “That the WHO tells you that your drug is an essential medication, it is the most powerful thing you can get in the pharmaceutical sphere and the preparation of drugs,” says Fuster, says

The cardiologist also highlights the fact that the polypíldora, which in principle was designed for patients who have already suffered a cardiovascular accident, already begins to be indicated in the clinical guidelines of entities such as the European Cardiology Society for the treatment of coronary patients who have a low adhesion to the medication, regardless of whether they have suffered a heart attack or not.

“For me, the future of the polyper in primary prevention is difficult, I have always said it. That is why we launched ourselves to secondary prevention,” says the CNIC director. Time seems to have proved him right. On March 11, at the request of the magazine Nature Cardiovascular Research, The cardiologist signed an article on the trip of his polypíldora from his conception in 2007 to be recognized as an essential medication by WHO in 2023. “Fifteen years ago, we started the development of a polydora for secondary prevention as a means to improve accessibility to treatment and adherence. Tangible therapy, backed by a solid scientific basis, which could significantly raise the standards of cardiovascular preventive care worldwide, ”he concludes in his Fuster article.