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.

Delhi continues to battle high PM2.5 levels, even as a new study estimates that meeting the World Health Organization's (WHO) air quality guidelines could prevent or postpone 9.4 million deaths annually across 136 low- and middle-income countries (LMICs).

Following Diwali celebrations on November 8, PM2.5 concentrations in several parts of the capital reportedly exceeded 66 times the WHO's recommended 24-hour guideline. By November 11, Delhi's AQI had improved to below 300, in the 'poor' category, after several days in the 'very poor' and 'severe' categories.

Led by University of Cambridge researchers, the modelling study also found that cleaner air could reduce disease burden, healthcare costs and productivity losses.

What Did The Study Find?

Published in Environment International, the study assessed the health and economic benefits of reducing PM₂.₅ and nitrogen dioxide (NO₂) levels across 136 LMICs.

Researchers used pollution, population and health data to model the impact of meeting WHO air quality guidelines and interim targets.

The findings suggest that meeting WHO guidelines could:

• Prevent or postpone 9.4 million deaths annually linked to PM₂.₅
• Prevent or postpone 1.1 million deaths linked to NO₂
• Reduce deaths associated with PM₂.₅ by an estimated 6.6 million and those associated with NO₂ by 435,000, even under less stringent interim targets

Meeting PM₂.₅ guidelines could also mean fewer new cases of:

• COPD: 2.8 million
• Dementia: 1.1 million
• Coronary heart disease: 7.3 million
• Stroke: 2.3 million

Cleaner Air Could Save Billions

The researchers also estimated substantial economic benefits from meeting PM₂.₅ guidelines.

Annual direct medical cost savings could include:

• $11.8 billion for coronary heart disease
• $5.9 billion for stroke
• $8.6 billion for dementia

Productivity gains could reach $17.9 billion for stroke, $18.1 billion for COPD and $5.3 billion for coronary heart disease annually.

"Meeting the WHO's air quality guideline values will not be straightforward, but low- and middle-income countries have a critical opportunity to shape healthier futures as their populations grow and their cities expand," said Dr Haneen Khreis of IMS Epidemiology at Cambridge.

She called for better decisions on transport, urban planning and energy, saying these could significantly improve air quality and reduce pollution-related diseases.

What Causes PM2.5 And NO₂ Pollution?

Outdoor air pollution is a major environmental health risk, linked to respiratory and cardiovascular diseases, including asthma, COPD, heart disease and stroke, as well as dementia.

In 2021, the WHO revised its air quality guidelines, setting recommended limits for pollutants including PM₂.₅ and NO₂.

PM₂.₅ consists of particles measuring 2.5 micrometers or smaller. They can travel deep into the lungs. Major sources include vehicle exhaust, power plants, industrial emissions and construction dust. These particles can also form through chemical reactions in the atmosphere.

NO₂ is mainly produced by burning fossil fuels. Sources include vehicle exhaust, industrial emissions and gas stoves and heaters.

Air pollution is a particularly serious challenge in LMICs, where rapid urbanisation, economic development and increasing vehicle use have contributed to poor air quality.

Policymakers attending the 31st Conference of the Parties (COP31) in Türkiye must put health at the centre of every climate negotiation, Professor Marina Romanello, Executive Director of the Lancet Countdown, told HealthandMe in an exclusive interview.

Marina, who led the 2026 Lancet Countdown on Health and Climate Change report released ahead of COP31, outlined the growing health consequences of global warming and the urgent need for stronger climate action.

Drawing on findings from the report, Marina warned that climate inaction is putting lives, livelihoods and public health at risk.

The report noted that climate commitments made since the Paris Agreement have delivered measurable health benefits, but progress remains too slow and uneven.

“One of the things that we are calling for negotiators to realise is that when they go to COP, they're not just negotiating budgets or carbon emissions or degrees of heating. What they're negotiating is people's health,” Marina told HealthandMe.

“They're negotiating how many people die from climate change. They're negotiating how many of our children will grow in these dangerous environments and have less of a chance in life.”

She stressed the need to recognise that climate change is not just an environmental issue.

“It's important to be very clear that climate change is not just a problem of the inanimate world or even of nature and polar bears. It's a problem of people here and today, and that our failure to act is costing people's lives, livelihood and health.”

Health Must Be Included Across All COP Negotiations

Also read: Climate Change Is Already Harming Health: WHO Chief Pushes Antalya Initiative At COP31

Marina, who is also a researcher at University College London's Institute for Global Health, urged policymakers to integrate health into all COP31 discussions rather than confining it to side events.

“We're also calling for countries not just to have climate change as one of the action agenda items and side events, but to actually consider climate change throughout their whole negotiations. Every negotiation stream needs to have health considerations so that we are aware of the hazards and the dangers that we're dealing with here.”

Countries Must Go Beyond COP Commitments

Read More: COP31 Begins On Health Day: How Will Countries Measure The Health Impact Of Climate Change?

Marina described COP as “a baseline” and “a starting point”, stressing that countries could go much further than the commitments agreed at the conference.

She cited India as an example of a country that stands to gain significantly from accelerating its climate transition, pointing to its natural resources, technological capabilities and opportunities to improve public health.

“In a country like India, where you have so many natural resources, where you have such impressive technology development, where you have so many opportunities from healthier air, improving access to energy, improving the transition towards more resilient, sustainable food systems, you are standing to win so massively from an accelerated transition at a country level.”

Marina also pointed out that countries rarely account for the health implications of their mitigation and adaptation plans. These include both potential negative impacts and the significant health benefits that stronger climate action could deliver.

Taking these benefits into account, she told HealthandMe, that it could increase the overall return on investment and make climate action more cost-effective.

Three Policy Interventions Governments Must Prioritise

READ: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Marina outlined three key areas for government action at COP31:

1. Phase Out Fossil Fuels

Governments must prioritise phasing out fossil fuel use, particularly in urban centres where people live, she said.

“That will reduce the burden of air pollution and will mean that people have much less burden of chronic conditions and much less exacerbation of those conditions that they already have.”

2. Strengthen Healthcare Systems

Marina called for health systems to be equipped to respond to climate hazards and for healthcare professionals to receive training on climate change and health.

“They should know how to recommend better care and better preventative measures to their patients.”

3. Accelerate Emissions Reductions

Marina stressed that reducing greenhouse gas emissions must remain a priority for every country.

“We absolutely need to stop our emissions, our greenhouse gas emissions. Every country needs to pursue efforts to reduce their greenhouse gas emissions. It's a global health imperative.”

She added: “Reducing our greenhouse gas emissions in line with the Paris Agreement, redoubling efforts to mitigate climate change is a health imperative.”

Ozempic and Wegovy, whose active ingredient is semaglutide, have transformed the treatment of type 2 diabetes and obesity. These medications have also been linked to improved fertility in some cases. However, GLP-1 medications are not recommended during pregnancy.

Now, a study in pregnant sheep has found that semaglutide significantly reduced blood flow to the uterus and oxygen levels in developing fetuses.

Led by researchers at Adelaide University, the animal study raises questions about the potential effects of these medications on fetal development.

While the findings are preliminary and have not been established in humans, they highlight the need to understand the risks of exposure during pregnancy, particularly among women who may conceive unexpectedly or continue treatment before realising they are pregnant.

Semaglutide Reduced Blood Flow Within Two Hours

Also read: Woman Says GLP-1 Drug Helped Her Conceive

Adelaide University researcher Dr Mitchell Lock noted that although weight-loss medications have become incredibly popular, there's still a lot we don't know about how they might affect a developing baby.

With the new study, they aimed to better understand the potential effects of GLP-1 drugs during pregnancy so women and health care professionals can make informed and safe decisions about their use.

In the study, the researchers used magnetic resonance imaging (MRI) to assess maternal heart function and uterine blood flow before and after administering semaglutide to pregnant sheep. They also collected fetal blood samples and monitored blood pressure and heart rate to evaluate the drug's immediate effects.

The findings, published as a conference abstract in the journal Heart, Lung and Circulation, showed that semaglutide affected the mother's cardiovascular system and the supply of blood and oxygen to the developing fetus.

"Within two hours of administering semaglutide, we found that the amount of blood pumped by the mother's heart had significantly decreased, reducing blood flow to the uterus and lowering oxygen levels in the developing fetus," Lock said.

"Oxygen is essential for healthy fetal growth and development, so any reduction in its supply raises questions about what might happen if exposure to the drug continues throughout pregnancy."

Long-Term Effects On Fetal Development Remain Unclear

Read More: GLP-1 Drugs Ozempic, Zepbound Use Rises 24-Fold Among American Women After Childbirth

Senior researcher Janna Morrison said the findings highlight the need for further research into the potential effects of prolonged semaglutide exposure during pregnancy.

"Our findings suggest a potential risk to fetal development, but we haven't yet established whether these short-term changes affect fetal growth, what happens over a longer period of semaglutide use or whether similar effects could occur in human pregnancies," Morrison said.

Can GLP-1 Drugs Be Used During Pregnancy?

READ: GLP-1 Weight-Loss Drugs May Improve Fertility In Men With Obesity, Study Suggests

GLP-1 medications are not recommended for weight loss during pregnancy. Women planning to conceive should consult their healthcare professionals about discontinuing treatment.

For semaglutide, prescribing guidance recommends stopping the medication at least two months before a planned pregnancy.

Women who become pregnant while taking the medication should seek medical advice. Those who are breastfeeding should also discuss its use with their healthcare professional.

The American College of Obstetricians and Gynecologists advises against weight-loss medications during pregnancy. Women considering GLP-1 treatment should discuss its risks, benefits and timing with their healthcare professionals, particularly if they are planning to conceive.