Take this, prevent that
A pill a day could cut your risk of heart disease and cancer, prevent breakouts and breakdowns, even help you avoid a stroke. The medicine of tomorrow has arrived, but should you take it?
Photo by Jim Jordan
Wouldn't it be wonderful if you could take a pill that would slash your risk of heart disease or breast cancer by nearly half? Or a capsule that would ease your concern about developing Alzheimer's disease in old age? Using medications to prevent chronic disease in otherwise healthy people has become a research priority, and some drugs have already been approved by the Food and Drug Administration for this purpose. "Prevention is truthfully what medicine is all about today," says Dana Simpler, M.D., a Baltimore general practitioner and internist.
The concept of preventive pill-taking reached new levels of interest last fall when researchers proposed in the British Medical Journal that six specific drugs and vitamins be combined in a "polypill" that would cut the risk of heart disease by 88 percent and stroke by 80 percent. Used widely, such a pill "would have a greater impact on the prevention of disease in the Western world than any other single intervention," the researchers predicted.
The polypill--which would contain aspirin, an anticholesterol statin, folic acid, and low doses of three blood-pressure reducers--is a bold strategy worthy of consideration, wrote Anthony Rogers, M.D., co-director of the Clinical Trials Research Unit at the University of Auckland in New Zealand, in an accompanying editorial. "Only large reductions in smoking or a few other leading health risks could achieve so much health gain."
the power of prevention
Last November, a pivotal study on two cholesterol drugs found that patients taking Lipitor (atorvastatin calcium) had a reduction in the progression of hardening of the arteries compared to those who took Pravachol (pravastatin sodium). The Reversal study (for "reversing atherosclerosis with aggressive lipid lowering"), presented at the annual meeting of the American Heart Association, measured the effectiveness of the statins in reducing plaque buildup within an artery supplying the heart. Lipitor reduced the buildup, while Pravachol increased it.
The statin investigation shows the wisdom of aggressively managing cholesterol levels to reduce the risk of heart disease, says the study's lead author, Steve Nissen, M.D., of the Cleveland Clinic Cardiovascular Coordinating Center.
As the popularity of statins has soared, investigators are testing them for their effectiveness in preventing heart disease, lowering the risk of dementia and stroke, and curtailing relapses in people with multiple sclerosis.
