Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.

The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.

Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.

Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:

Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.

Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.

Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.

Simplicity and Affordability of the Polypill Strategy

One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.

Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:

"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."

Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.

The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.

Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.

Is This a Case of Over-Medicalisation?

One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.

Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:

"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."

He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.

With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.

As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.

Obstructive sleep apnea (OSA) affects nearly 1 billion adults worldwide and is linked to cardiovascular disease, stroke and increased mortality.

Eli Lilly’s GLP-1 drugs Mounjaro and Zepbound, which contain tirzepatide, have shown promise in treating sleep apnea in a new review.

While continuous positive airway pressure (CPAP), which uses air pressure to keep the airway open during sleep, remains the standard treatment, some people struggle to use it long term. Adherence rates of 30% to 60% limit its effectiveness at the population level. The review showed that GLP-1 medications may be a potential complementary therapy alongside CPAP.

GLP-1 Drugs And Sleep Apnea

Researchers from the University of Pittsburgh Medical Center, Pennsylvania, reviewed existing evidence on GLP-1 receptor agonists (GLP-1 RAs) for OSA.

Six meta-analyses found consistent reductions in the apnea-hypopnea index (AHI), ranging from 5.7 to 21.9 fewer events per hour.

The Phase 3 SURMOUNT-OSA trials found that tirzepatide reduced AHI by 20 to 24 events per hour compared with placebo. Between 42% and 50% of patients achieved disease remission.

Weight loss is the main established mechanism. GLP-1 RAs may reduce tongue fat and parapharyngel fat, which contribute to airway collapse.

Researchers also identified potential weight-independent effects involving chemosensitivity, leptin pathways and NLRP3 inflammasome suppression, although these mechanisms remain under investigation.

GLP-1 Drugs Vs CPAP

GLP-1 RAs did not match CPAP efficacy, with approximately 22 versus 31 fewer AHI events per hour. Cardiovascular benefits remain unproven, and weight regain commonly occurs after treatment stops.

The researchers said GLP-1 drugs are best positioned as complementary therapy alongside CPAP and other treatments.

The drugs may be appropriate for people with a BMI above 30 who are unable to tolerate CPAP or have obesity-related comorbidities. They are less likely to benefit people without obesity or those with primarily anatomical airway obstruction.

“This review suggests that GLP-1 RAs offer otolaryngologists a disease-modifying adjunct for obesity-related OSA that is best positioned as complementary therapy alongside CPAP, preoperative optimization before upper airway surgery, or potentially to expand hypoglossal nerve stimulator candidacy,” said the researchers in the paper published in JAMA Otolaryngology–Head & Neck Surgery.

What Is Sleep Apnea?

OSA occurs when the airway becomes blocked during sleep, causing breathing to repeatedly stop and restart. These interruptions can occur five to 100 times an hour and can lower oxygen levels and disrupt sleep.

In OSA, the airways become partially or completely blocked when the muscles in the head relax during sleep. This can cause soft tissue to obstruct the windpipe, making it difficult for air to pass through.

While asleep, the chest muscles may work harder than usual to reopen the airway. This can cause jerks, deep gasps and repeated disruptions to sleep.

Symptoms Of Sleep Apnea

Common symptoms include:

• Loud snoring
• Gasping during sleep
• Breathing pauses during sleep
• Morning headaches
• Restless sleep
• Difficulty staying asleep
• Mood changes
• Dizziness
• Dry mouth on waking
• Excessive daytime sleepiness
• Fatigue
• Difficulty concentrating

People may not notice these symptoms themselves, but a partner or family member may observe them.

Can Sleep Apnea Be Prevented?

Measures that may help prevent or manage sleep apnea include:

• Practicing good sleep habits
• Maintaining a healthy weight
• Quitting smoking
• Using CPAP when prescribed
• Avoiding alcohol.

The 9/11 attacks on the World Trade Center killed nearly 3,000 people, and scores of young children, infants and toddlers, as well as some still in the womb, were exposed to toxic air in and around Manhattan and the Ground Zero site.

Within seconds of the collapse of the World Trade Center, the area was filled with a cloud of dust. In the days, weeks and months that followed, the area was exposed to settling dust containing pulverized concrete, glass fibers, asbestos and other pollutants.

Children Exposed To 9/11 Toxins

While various health program have emerged to address the ongoing health effects of the September 11 attacks, there have been few focused on children exposed to them.

Scientists say exposure to toxins may have long-term health consequences, including trauma, chronic illnesses, cancers, cardiovascular diseases and reproductive health problems. Some of these effects may only now be emerging as those children reach their 30s and early 40s.

Major questions remain about whether exposure to toxins and trauma on 9/11 and afterward increased their long-term health risks, according to scientists.

The federal World Trade Center Health Program and the Centers for Disease Control and Prevention (CDC) are behind the Youth Research Cohort, which was first announced by the US Congress in 2022.

The project is expected to kick off on July 1, 2027, according to a government website announcing federal grants. The same site says research will begin once the number of people participating “grows large enough.”

Also read: 9/11 Toxic Air Exposed Thousands: What New Records Reveal 25 Years Later

Who Will Be Eligible For The Study?

The CDC has specified that study participants will have been 21 years old or younger, or in utero, and living below 14th Street in Manhattan or anywhere in Brooklyn on and after 9/11.

A cohort of similarly aged but unexposed individuals will be recruited for comparison.

It is not clear how many participants the CDC hopes to recruit, but $50 million in programme funding is estimated.

What We Know About Long-Term Health Effects

In adult survivors and first responders, dozens of types of cancers and other health issues related to their exposure have been identified.

Since 9/11, more than 96,000 people have been diagnosed with physical and mental health conditions as a result of exposure to the dust, smoke, debris and traumatic events of 9/11, according to the WTC Health Program. The program says it has recorded more than 9,000 deaths since 9/11, but it is not clear what role 9/11 played in those deaths.

Cancer Cases Continue To Rise

Read More: PM2.5 Linked To 8.82 Million Global Cancer Cases, Accounts for Largest Share Among Pollutants: Study

Cancer cases linked to the September 11, 2001, World Trade Center terror attacks have surged 75%, according to new research, highlighting the ongoing health crisis even 25 years later.

The research was conducted by Northwell Health’s Long Island Jewish (LIJ) Medical Center, which provides free medical monitoring to people affected by the aftermath of the attacks at New York’s World Trade Center.

About two-thirds of all enrollees are certified for at least one WTC-related health condition, while 30% of those enrolled through Northwell have battled cancer. That number is expected to rise dramatically over the next decade.

A trove of newly released files by New York City Mayor Zohran Mamdani also indicated that toxic air persisted for months after the 9/11 attacks on the World Trade Center and that officials played down the health risks.

The Supreme Court has pushed for stronger front-of-pack warnings on packaged foods high in sugar, salt or fat, questioning the Food Safety and Standards Authority of India’s (FSSAI) two-phase labelling proposal.

On Thursday, Justice J.B. Pardiwala questioned the need for a two-phase approach.

“It has to be sugar and salt. Only then will you ask them to put a label?” Pardiwala said, stressing the word “and”.

FSSAI’s lawyer, Additional Solicitor General Brijender Chahar, said the regulator could now roll out the phases “in one go”, Reuters reported.

This could mean foods high in even one of the three nutrients — added sugar, salt or fat — would carry a red hexagonal warning.

The proposed labels would read “HIGH FAT”, “HIGH SUGAR”, “HIGH SALT” or “HIGHLY SWEETENED BEVERAGE”, making it easier for consumers to identify products high in these nutrients.

What Was FSSAI’s Earlier Proposal?

Also read:FSSAI Proposes Red Front-Of-Pack Warning Labels On Junk Food: How Will This Benefit Consumers’ Health?

Under the earlier proposal, red hexagonal warnings would apply to products exceeding limits in at least two of three categories — added sugar, salt or saturated fat. Stricter rules would follow in the second phase.

Health experts criticized the proposal, arguing that the two-nutrient requirement could allow several products to escape warnings. Reuters reported that the approach had been described as an “industry-friendly loophole”.

Experts also raised concerns over the use of added sugar instead of total sugar and the size of the warning label.

India had already defined high-fat, sugar and salt (HFSS) foods in its 2022 draft regulations and invited public feedback.

Dr. Sivaranjini Santosh, a paediatrician and social activist, said in a post on X that the FSSAI proposal had “too many loopholes”.

How Could Red Warning Labels Help?

Packaged foods generally carry nutritional information on the back or side, requiring consumers to turn the packet around to compare products.

A prominent red warning on the front could make high levels of sugar, salt or fat easier to spot, particularly when comparing similar products or choosing food for children.

The aim is not necessarily to tell consumers to never eat a product, but to provide information before purchase and help them decide how often to consume it.

However, a warning label cannot compensate for an overall unhealthy diet.

Read More: Synthetic Paneer Whitened With Chuna Busted In Delhi: How Dangerous Is It For Your Health?

91% Consumers Support Front-Of-Pack Warnings

A recent LocalCircles survey of more than 83,000 consumers across 314 districts found strong support for front-of-pack warnings.

Around 80% wanted FSSAI to mandate warnings, while another 11% wanted them specifically on ultra-processed foods. Overall, 91% supported front-of-pack warnings in some form.

Around 44% preferred a red warning symbol for products high in sugar, salt or saturated fat, while 27% chose traffic-light color coding. Only 2% preferred the conventional black-and-white nutrition panel.

About 450 million Indians could be obese or overweight by 2050, according to a recent study published in The Lancet.

Ultra-processed foods have also been linked to a range of health concerns, including diabetes, high blood pressure, cancers, and fatty liver adding to calls for clearer information on packaged foods.

“We are concerned with the health of people, more particularly growing children. We have taken it up very seriously. We expect one and all to extend their cooperation to a cause which is in national interest,” the Supreme Court said.