Wednesday, April 01, 2009

'Super pill' could halve heart risks?

The papers are full of this bit of speculation. The theory is an old one but what is reported below proves nothing. You take blood-pressure-lowering drugs and cholesterol-lowering drugs and your blood pressure and cholesterol levels fall. Big surprise! The authors are only TALKING about the effect on mortality. They have no evidence on it. Given the side effects of statins in particular, the pill could INCREASE mortality. And a trial on people who already have heart disease tells you nothing certain about the general population anyway. Any benefit could well apply only to people with certain genetics, for instance

HEALTHY people may be able to cut their risk of heart disease in half by taking a "super pill" combining three drugs, a study says. The pill, which combines low doses of aspirin and two drugs to lower blood pressure and fight cholesterol, was compared to eight other therapies in the three-month study involving 2053 patients in India.

"The thought that people might be able to take a single pill to reduce multiple cardiovascular risk factors has generated a lot of excitement. It could revolutionise heart disease prevention as we know it," said principal researcher Salim Yusuf.

The Indian Polycap Study (TIPS) was the first to evaluate how well the polypill is tolerated and whether it leads to meaningful changes in the body. Carried out by St John's Medical College in Bangalore, the study recruited patients from 50 heart centres between March 2007 and August 2008.

Researchers found that by taking the pill healthy individuals might be able to cut their risk of cardiovascular disease by 50 to 60 per cent. "This trial is a critical first step to inform the design of larger, more definitive studies, as well as further development of appropriate combinations of BP lowering drugs with statins and aspirin," said Dr Yusuf.

The researchers found that the patients taking the polypill showed significant falls in cholesterol levels as well as in blood pressure.

The study, which will also be published in The Lancet, was unveiled at the 58th conference of the American College of Cardiology which has been meeting since Saturday in Orlando, Florida.


A vision of our fat future

The British writer below is acute enough to recognize that being fat is mostly genetic but unfortunately buys into the myth that being fat is unhealthy

Susan Ringwood, chief executive of Beat, the eating disorders charity, says those who overeat are, in many cases, as worthy of concern as those who undereat, but for obvious reasons don’t get as much attention as skeletal teenage girls who look almost like size-zero models.

“Overeaters know they are unhealthy. They know about their five a day but it’s no easier for them to make the long-term lifestyle changes to their diet than it is for anorexics,” she says. She also points out that when it comes to the spectrum of eating disorders, those who don’t eat, the anorexics, constitute only 10% – the tip of the iceberg. Most eat too much.

In the US they are way ahead of us. There, obesity has achieved the status of a “disease” even though it is caused by a combination of voluntary and involuntary factors: genes, sedentary lifestyles in the suburbs, the McDiet and an inability for various reasons to lose weight through exercise.

Stateside, the long-term effects and costs of what is regarded as the – sorry – ballooning obesity “epidemic” is the hottest issue in public health. Here, too, where two-thirds of us are carrying too many pounds of adipose tissue, we are beginning to wake up; the word “pandemic” has been applied to the nation’s thickening waistline by Brio, the Bristol University Research Into Obesity.

Dr James Le Fanu, the medical historian and GP, is one clinician who challenges the orthodoxy that chubsters have only themselves to blame. He thinks the cause of obesity is “not known”. He’s seen women on restricted diets failing to lose a single pound. His guess is that we all have thermostats, which govern our “energy balance” – how much weight we lose or gain relative to what we put in our mouths. He also believes that fatness runs in families, from observing this in his surgery.

This is the essence of the Chawner case, too. “We’re fat because it’s in our genes. Our whole family is overweight. Even when Philip went into hospital with septicaemia in 2006 he didn’t lose any weight. And he was eating tiny portions.”

Right, then. Fair enough. I am prepared to concede that being fat or being thin is partly in our DNA. But come on – it’s also a matter of choice, habit, lifestyle. It’s like smoking, drinking, sun-bathing – you can choose to gorge. Only, unlike smoking, which is in decline, more and more of us are “choosing” to be fat, or allowing our children to get fat, and that’s not good for any of us.

According to some estimates, obesity could cost the NHS in England £6.3 billion by 2015 unless the flab is fought. Some councils are having to shell out thousands of pounds on fat-friendly services, such as wider crematorium furnaces and bigger school chairs.

Whatever obesity’s cause, and however sympathetic we may or may not be, it doesn’t matter. Obesity is a national emergency. It is, yes, the new smoking. Rather than see them like animals in the zoo, we should commend the Chawner family freak show for displaying their bulk. They have drawn our horrified eyes to a health crisis that concerns us all.


1 comment:

Anonymous said...

I recently lost ALL of my body fat, namely both subcutaneous (six pack is back after 20 years) AND within my organs so my liver especially got tiny and stopped pushing my heart against my stomach and in turn against my rib cage to create heart pain. And what I notice most is the lack of need of deep sleep along with a sudden lack of GREASY skin (!) as if the fat was bleeding out of my pores before. Wow. Have to get before/after shots but my before shots are missing. Oh well.