WORLD HEART DAY. 29th Sept 2012.: ERADICATION OF CORONARY HEART DISEASE WITH A POLYPILL.

Many things are scheduled for today.Besides mooncakes, it is also World Heart Day.
In conjunction with this I have chosen to highlight a meeting which took place this week in Hamilton, Ontario, Canada at the McMaster University Population Health Research Institute. Their distiquished cardiologist, Dr Salim Yusuf, had organised a Global Summit on Combination Polypharmacy for Cardiovascular Disease.
This arose out of a piece of research by Sir Nicholas Wald and Dr Malcolm Law of University of London, published in the British Medical Journal 2003. Drs Wald and Law, had done many meta-analysis on clinical data from research papers of drug combinations and their reduction in CV disease. In their landmark BMJ 2003 paper, they highlighted ( from their meta-analysis ) that if all of us were to take a polypill, consisting of 6 drugs at half doses ( the 6 drugs are a statin, 3 anti-hypertensives, aspirin and folic acid ), we will reduce cardiovascular disease by 88% and strokes by 80%. We have a side effect risk of 8-15%. They advocate that all males above 55 years should take this, without any need for clinicians advice.

The challenge is, should we all do it.
Dr Salim's meeting in McMaster this week, is to pool together, the experts ( and there were some big names there including Valentin Fuster, Sydney Smith.
The consensus at the end , is that we need more data. Obviously there are some ( like myself ) who like to push lifestyle modification, as we are afraid of pills and side effects. There are some who have a genuine concern of side effects, taking a 6 in1 pill. There are some who feel that there is a lack of randomised controlled trial. Afterall, much of Dr Wald and Law's publications were on meta-analysis and assumptions..
Let us not talk about 88% and 80%. Will you take a pill, which contain small doses of a statin, a thiazide, a beta blocker, and ACE-I, folic acid, and aspirin, to reduce your chance of getting CAD by 50% ? Will you?? Will this help in a campaign to eradicate CAD, the world's largest pandemic, and the cost of a major portion of our healthcare budget.

Incidentally, today will also see a soft launch of the ABSORB stent or what the company, Abbott Vascular, likes to call, the Bioresorbable Vascular Scaffolding System, at a meeting at KL Hilton, tonight.

HAPPY WORLD HEART DAY.
HAPPY MID-AUTUMN FESTIVAL.