More misleadings

More Misleadings

For some years several authors have suggested to prevent cardiovascular disease by a polypill, a pill that consists of several “anti-atherosclerotic” drugs, but hitherto no trial has been able to prove the benefit of this method. 

Recently, an international group of researchers have published the results from a five-year long polypill trial  ncluding almost 7000 Iranian people in Lancet. In addition to a statin drug (atorvastatin) the polypill included aspirin and two antihypertensive drugs (hydrochlorothiazide and either enalapril or valsartan). According to the authors, using polypill was effective in preventing major cardiovascular events. Medication adherence was high, and rates of adverse events were low. The polypill strategy may be considered as an additional effective component in controlling cardiovascular diseases. 

The trial and its results have been reported uncritically in the media all over the world, for instance in The Independent, BBC, Financial Times, The Guardian and many more. None of them have mentioned anything about the serious errors in the way the trial has been performed and presented. 

I am convinced that most people take preventive drugs to prolong their life. In this experiment fewer died from cardiovascular diseases in the polypill group than in the control group, but there were more who died from other causes. Totally, 202 died in the polypill group and 222 in the control group. As the treatment group included 3421 participants, it means that to save one life, you have to treat 171 people with a polypill for five years. 

Neither was the lowering of ”serious events” impressive. To prevent one event, you have to treat 53 people for five years. Add also that even revascularization (the surgical restoration of one of the heart´s arteries) was defined as a “serious event”, and that many myocardial infarctions and strokes may heal without any health consequences.

Considering that more than 20% of statin-treated ”patients” suffer from serious side effects, and that the other drugs included in the polypill have many side effects as well, it is highly unlikely that “rates of adverse events were low” and similar to the number among the untreated control individuals. The explanation is most likely that more than 2000 in each group refused to participate in the trial when they learned about its design. Probably they have tried some of the drugs previously and experienced their unpleasant side effects.

As I told you in my February Newsletter, our review published last year in Expert Review of Clinical Pharmacology was the most often downloaded paper among more than 10,000 scientific articles published by Taylor and Francis. Today it has been downloaded by almost twice as many, but although we have documented in detail that the cholesterol campaign is based on fraudulent science, nothing has happened. As far as I know, all health authorities in the world just continue. If something has happened in your country, please tell me.
Uffe Ravnskov
PS This letter has been sent to almost 1600 scientists, colleagues and wise laypeople