Polypill, fish oil or exercise?

There has been a lot of press this week about a study conducted in India using the “Polypill,”  a combination of a beta-blocker, a diuretic, an ace inhibitor, folic acid, a statin and aspirin rolled into a single pill.  The intent of the pill is to reduce four risk factors for cardiovascular disease: LDL cholesterol, blood pressure, platelet function, and serum homocysteine.  The new study involved testing the Polypill on 2,053 subjects aged between 45 and 80 for 12 week, people without cardiovascular disease (CVD) but having one major risk factor for CVD such as high cholesterol, diabetes,  smoking, or high blood pressure.  The pill was found to reduce high blood pressure and LDL cholesterol without major side-effects – not surprising given the pill’s ingredients.  Of course, the study was far too short to show any final outcomes.  The Polypill has received somewhat of a mixed reception.  One thoughtful analysis argues that the same benefits can be achieved by taking Essential Fatty Acids, such as in fish oils. “Thus, EFAs and their metabolites show all the classic actions expected of the ‘polypill’. Unlike the proposed ‘polypill’, EFAs are endogenous molecules present in almost all tissues, have no significant or few side effects, can be taken orally for long periods of time even by pregnant women, lactating mothers, and infants, children, and adults; and have been known to reduce the incidence cardiovascular diseases including stroke.“  Others are also skeptical that the Polypill should be taken by everyone in lieu of good lifestyle preventative measures.  Medpagetoday quotes Robert Bonow, M.D., professor of medicine at Chicago’s Feinberg School of Medicine at Northwestern University: “We already have a polypill — it’s called exercise,”