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.

Most people often wrap up their day at work with a sense of stress and severe exhaustion. But if you are part of the group that experiences severe headaches after office hours, it could be because of one common habit that may be causing you discomfort — chronic stress. When the mind keeps racing all day long because of deadlines, tension, and pressure, even during breaks, it leaves behind a sense of urgency. And that sense of urgency does not mitigate or come to an end when the day ends.

Why does stress build up even after work?

Several times, there are difficult or unpleasant situations at work — it could be because of unfinished tasks and conversations that play and replay in the mind. The nervous system, therefore, gets overburdened, thereby leading to headaches. According to doctors, a lot of corporate employees experience this pain after a day at their high-pressure jobs. And while it may sound like something that is out of your control, there is something that you can do.

How to deal with chronic stress after work?

Stress inherently is not bad for you, but only if it occurs in short bursts. In that case, it can improve performance, focus, and may even prepare the body to handle challenges. Problems, however, arise when stress becomes chronic. As a result, the nervous system starts to process both pain and stress at the same time, and while one is built to be highly adaptable, stress starts to respond to external and internal factors. When the brain continues to receive signals without getting ample time for recovery, the body enters a state of prolonged alertness.

In a sensitised state, situations that would otherwise be interpreted as minor may even get ignored. This can increase heart rate and muscle tension, thereby putting the nervous system into a fight-or-flight mode. In cases of constant headaches, sensitisation can lower the pain threshold. Consequently, headaches begin and become much harder to stop. Over time, this constant activation can disrupt the body's natural balance and create an environment for headaches to worsen.

Chronic stress and migraines

Chronic stress acts as a trigger for migraines — it can even worsen the discomfort. The neurological system of people experiencing migraines is more responsive to changes in hormones, environmental factors, and sleep patterns. Constant exposure to a stressor, therefore, can drive the severity and frequency of migraines. To make matters worse, muscle tension in the shoulders, neck, and scalp can also trigger headaches. Extended periods of sustained concentration and sitting can cause headaches later in the day.

Can sleep help reduce stress headaches?

Chronic stress has a debilitating impact on sleep quality as well. People who feel persistently wired at the end of the workday struggle to fall or stay asleep. As a result, the brain fails to recover properly. Poor sleep can therefore worsen the stress cycle, leading to headaches the next day as well. The loop is difficult to break, and excessive fatigue building up over time can make you feel overwhelmed. Over time, this loop leads to a decline in productivity, focus, and the ability to solve problems.

Public health officials in South Wales, UK, have issued an alert on a localized outbreak of hepatitis A, and have urged residents to maintain hygiene as well as vaccinate children.

Cases of hepatitis A involving the same strain have been identified in three separate households in Barry, according to Public Health Wales.

The health body, in a statement, said the strain’s characteristics “suggest the infection may be spreading locally.” Investigations into the “small number” of cases are ongoing.

To curb the outbreak, the officials have also issued an urgent appeal to parents to ensure their children remain “vigilant with their handwashing.”

Those infected are “receiving appropriate care and are recovering well,” Public Health Wales said. As a precaution, close contacts of the affected individuals have also been offered vaccination.

What Is Hepatitis A?

Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV). It spreads mainly through contaminated food or water, or through close personal contact with an infected person.

The infection can lead to liver inflammation, jaundice, extreme fatigue, and stomach pain. In most cases, it is a short-term illness that clears on its own without specific treatment, although severe cases can occur. Unlike hepatitis B or C, hepatitis A does not usually cause long-term liver damage.

According to the World Health Organization (WHO), vaccination remains the most effective way to prevent infection.

Also read: Hepatitis Infections Claims 1.3 Million Lives Worldwide, India Among Top Contributors: WHO

Symptoms of Hepatitis A

Symptoms usually appear a few weeks after exposure to the virus, although some people may not develop noticeable signs. According to the Cleveland Clinic, symptoms can include:

• Persistent fatigue and weakness
• Sudden nausea, vomiting, or diarrhea
• Pain or discomfort in the upper right side of the abdomen near the liver
• Pale or clay-colored stools
• Reduced appetite
• Mild fever
• Dark-colored urine
• Joint pain
• Yellowing of the skin and eyes (jaundice)
• Severe itching

Can Hepatitis A Be Prevented?

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“The best way to prevent the spread of hepatitis A is to wash hands thoroughly with soap and water. This is important after using the toilet, changing nappies, and before preparing or eating food,” said Susan Mably, Consultant in Health Protection for Public Health Wales.

Vaccination against hepatitis A is also highly effective in preventing the disease.

Doctors recommend the vaccine for:

• Children older than 12 months
• Adults at risk of exposure at home or work
• Travelers visiting regions where the virus is more common
• People with existing liver conditions

• drinking boiled or bottled water,
• avoiding food from unhygienic sources,
• peeling fruits at home and not getting pre-cut from stores.

If someone in the household is infected, cleanliness becomes even more important. Surfaces should be disinfected, food prepared carefully, and personal items not shared.

Safe sexual practices also matter, as the virus can spread through oral-anal contact. On a broader level, preventing future outbreaks requires more than short-term fixes. Improving water quality, repairing sewage systems, and strengthening public health surveillance are essential to stop the cycle from repeating.

Stroke is a medical emergency that can lead to long-term disabilities if not diagnosed in time. Yet, many do not realise that a high resting heart rate could be linked to a higher risk of stroke. Once a concern for the elderly, stroke can now occur in young people as well, and doctors say that this is a worrying trend. Now, findings from a large study indicate that a low resting heart rate could be just as bad when it comes to stroke risk, challenging the common perception that fewer heartbeats per minute guarantee good heart health. But how can you be certain of your heart rate?

Also Read: Hantavirus Outbreak Explained: WHO Confirms Evacuation of 3 Suspected Cases Amid Rising Death Toll

What do doctors say about stroke risk and heart rate?

The common idea, according to doctors, is that a higher heart rate is linked to a higher stroke risk. However, the relationship is not linear. Researchers presented the results at the European Stroke Organisation Conference. They stated that they had identified that people who were at a relatively lower risk of stroke had a heart rate between 60 and 70 beats per minute. Resting heart rate refers to the number of times the heart beats in a minute when the body is at rest, such as when sitting or lying down. The normal heart rate for adults is 60 to 100 beats per minute.

For this, researchers analysed 460,000 people in the UK Biobank, aged 40 to 69 years. Experts monitored participants for an average of 14 years and, during that time, recorded over 12,000 stroke cases. When compared with people whose heart rate was in the middle range, researchers noted that people with a heart rate of 90 had a 45 per cent higher risk of stroke. Surprisingly, people with a heart rate of less than 50 had a 25 per cent higher risk of stroke. This was even after scientists adjusted for other stroke risk factors, such as blood pressure, age, and atrial fibrillation.

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Does low heart rate also spike stroke risk?

When the data was broken down by stroke type, a low heart rate was linked to ischaemic stroke risk, a condition caused by blocked blood circulation to the brain. It is the most common type of stroke. A higher heart rate, on the other hand, was linked to both ischaemic and haemorrhagic strokes, the latter characterised by bleeding in the brain. A low heart rate can lengthen pauses between heartbeats, reducing steady blood flow to relatively smaller brain vessels and making blockages more likely. The symptoms are:

1. Shortness of breath
2. Dizziness
3. Chest pain
4. Fainting
5. Confusion
6. Light-headedness

A higher heart rate can also increase stress on blood vessel walls, making them more prone to bleeding. However, researchers say that most of this is still hypothetical — a low heart rate could still be indicative of fitness in people who work out regularly. Doctors say that a low heart rate is a good way to measure heart disease risk. While the findings are observational, it cannot be conclusively said that a high or low heart rate can directly lead to a stroke. More research is required in this area before a conclusion can be reached.