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.

A popular organic applesauce has been recalled in the US after routine testing by the US Food and Drug Administration (FDA) revealed high levels of patulin, a toxin produced by certain molds that can grow on apples.

Wakefern Food Corp. voluntarily recalled select containers of Wholesome Pantry Organic Unsweetened Apple Sauce after the patulin levels were found to exceed food safety limits. No illnesses linked to the toxin have been reported yet.

The recall involves 23-ounce plastic jars with UPC 04119005677 and a best-by date of June 16, 2027. The product was sold through ShopRite, Price Rite Marketplace, The Fresh Grocer, Gourmet Garage and Fairway Market.

What Is Patulin?

Patulin is a mycotoxin, meaning it is a toxic chemical produced by certain species of fungi or mold.

The FDA identifies molds from genera including Penicillium, Aspergillus and Byssochylamys as sources of patulin. Apples are one of the best-known sources, particularly when fruit is bruised, damaged, rotten or improperly stored.

When contaminated apples are used to make products like apple juice or applesauce, the toxin can remain it. The pasteurisation does not eliminate patulin, so simply heating an apple product is not a reliable way to get rid of the toxin.

Also read: Beer Is Getting A 'Health Makeover': Do Protein Or Electrolytes Really Make It Healthier?

How Dangerous Is Patulin?

The health concern depends on the amount and duration of exposure to patulin. According to the FDA, consuming food or beverages containing high levels of patulin may cause nausea and vomiting, while evidence also indicates that the toxin can damage cells. The agency monitors patulin because prolonged exposure to elevated levels may pose a serious health hazard.

The FDA has established an action level of 50 parts per billion (ppb) for patulin in apple juice, apple juice concentrates and apple juice products.

This does not mean that eating a food once above the regulatory limit automatically causes poisoning. Food safety limits are designed to control exposure and reduce potential health risks, particularly when contamination could occur repeatedly.

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Patulin In Applesauce

Molds formed due to patulin can grow on apples that have been bruised, damaged or allowed to rot. Contamination can also happen during storage.

The problem can be difficult to identify simply by looking at the finished food. FDA guidance notes that some contamination can originate from internal problems like core rot that may not be obvious from the outside of an apple. Removing damaged fruit before processing is therefore an important control measure.

So, anyone who has the recalled Wholesome Pantry Organic Unsweetened Apple Sauce at home should not consume it.

Consumers should check the jar for the 23-ounce size, UPC 04119005677 and best-by date June 16, 2027. The company says recalled products can be returned to the store for a refund or replacement.

Stopping GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and Zepbound may cause some of their cardiovascular benefits to fade, a large new study suggests.

Researchers from Washington University in St. Louis found that people who stopped GLP-1 treatment had a progressively higher risk of major cardiovascular events, including heart attack, stroke and death. After two years off treatment, their risk was 22% higher than among those who continued taking the drugs.

The findings, published in BMJ Medicine, are significant as GLP-1 drugs are widely used to treat type 2 diabetes and obesity and have also been shown to provide cardiovascular benefits.

What Did The Study Find?

Researchers analyzed health data from 333,687 US veterans with type 2 diabetes over up to three years. Of these, 132,551 had been prescribed GLP-1 drugs, while 201,136 had been prescribed sulfonylureas, another class of diabetes medicines.

Treatment status was reassessed every six months. About 26% of GLP-1 users stopped treatment completely, while another 23% had a treatment gap of at least six months before restarting.

The longer people remained off treatment, the greater their cardiovascular risk.

After one year without restarting, the risk of major cardiovascular events was 14% higher than among continuous users. After two years, it was 22% higher.

"There is enormous exuberance about starting GLP-1 drugs, but not nearly enough attention to what happens when people stop," said senior author Ziyad Al-Aly, a clinical epidemiologist at Washington University.

Also read: Are GLP-1 Drugs Safe for Children? Study Finds Nutritional Deficiency in Nearly 17% Within a Year

Continuous Treatment Showed Greater Benefit

People who remained on GLP-1 drugs throughout the three-year study had an 18% lower risk of major cardiovascular events than those taking sulfonylureas.

That translated to about four fewer major cardiovascular events per 100 people over three years.

Those who remained on treatment for two or 2.5 years before stopping also had lower cardiovascular risk, by 7% and 15%, respectively.

However, people who stopped before 18 months did not have a significant reduction in cardiovascular risk compared with those taking sulfonylureas by the end of the study.

Treatment Gaps May Weaken Heart Protection

Interrupting GLP-1 treatment and later restarting it was associated with less cardiovascular protection. While continuous users had an 18% reduction in major cardiovascular events, those who stopped and later restarted had an average 12% reduction.

Even a six-month treatment gap was associated with a 4% to 8% increase in cardiovascular risk compared with continuous use.

Al-Aly said many patients stop GLP-1 drugs because of "cost, side effects or shortages."

"When they stop, it's not just weight that comes back; they experience a resurgence in inflammation, blood pressure, and cholesterol. Weight regain is visible; the metabolic reversal is not," he said.

"Our data suggest this metabolic whiplash is detrimental to heart health," Al-Aly added.

Read More: EXCLUSIVE: GLP-1 Drugs Are The ‘New Statins’, Says University Hospital Birmingham Professor

Can Restarting GLP-1 Drugs Restore The Benefits?

Restarting treatment appeared to restore some cardiovascular protection, but not all of it.

The researchers said the findings suggest that cardiovascular benefits gained during GLP-1 treatment may diminish after treatment is interrupted.

"Clinicians should treat adherence to GLP-1 treatment as an important outcome in its own right -- not an afterthought," Al-Aly said.

He added that healthcare systems should help patients manage side effects, address cost barriers and understand that GLP-1 drugs are used to manage chronic conditions.

The human brain has always been considered to be a single organ. But according to Stanford Medicine researchers, the brain's growth history indicates that it originates from two different populations of early cells that follow separate developmental paths.

The findings, published in Nature Neuroscience, suggest that the front and back parts of the brain develop from different types of progenitor cells, questioning the long-believed idea that the entire brain originates from one common cell.

An important point to note is that this does not mean that humans have two completely separate brains. The two developmental systems ultimately fuse together and function as one brain.

Mechanism Of Brain Forming From Two Cell Groups

During early development, cells called progenitor cells enable the production of specialised brain cells, including neurons. Researchers found that the cells that form the forebrain and midbrain follow a different developmental pathway from those that form the hindbrain, which includes the brainstem.

The forebrain is involved in neurological functions like language, consciousness and higher-level thinking. The hindbrain contains structures that control essential functions including breathing, heartbeat, sleep and swallowing.

Kyle Loh, associate professor of developmental biology at Stanford Medicine and senior author, said, “We’ve shown for the first time that the front of the brain arises from a totally different progenitor cell than the back of the brain.”

He added, “Our discovery means that we can now grow neurons from the back of the brain, the hindbrain, in a petri dish and study their functions.”

Also read: Is Controlling BP Enough After a Brain Bleed? Doctors Explain How to Prevent Another Stroke

A Significant Discovery

Scientists have been able to grow several types of human brain cells in the laboratory, but creating hindbrain neurons has been challenging.

The new findings give some clarity about why some previous approaches were unsuccessful. Researchers were attempting to transform forebrain or midbrain progenitor cells into hindbrain cells, but the Stanford team found that these cells are fundamentally different from the beginning of development.

Jokhai, one of the researchers involved in the study, explained, “Previous attempts to make hindbrain neurons likely tried to coax forebrain and midbrain progenitors into hindbrain cells, which our study shows is not possible.”

He added, “In stem cell biology, people are always fixated with creating the end cell type, like the neuron. But it’s important to begin at the earliest stages of embryonic development.”

Also read: Brain Health After 40: How Diabetes, Menopause And Early Detection Affect Dementia Risk | World Alzheimer’s Day

Study's Implications On Brain Disease Research

The discovery could have various practical implications for neurological research. The hindbrain and brainstem contain neurons involved in breathing, swallowing and movement, meaning researchers need reliable human cells to study diseases that damage these systems.

Stanford scientists say the new findings allowed them to understand and generate functional human hindbrain neurons in the laboratory. This could provide new models for studying conditions like amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA).

Instead of studying these diseases only in animals or using cells that do not accurately represent the affected brain region, researchers may now be able to grow relevant human neurons and investigate how they develop, malfunction and respond to different treatments.

The finding could therefore change not just how scientists understand the human brain's anatomy, but how they understand its origins and how they recreate different brain regions in the laboratory.