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.

The new breast cancer screening guidelines released by the American College of Physicians (ACP) call for mammography screening once every two years in asymptomatic, average-risk adult females, instead of the annual recommendation.

ACP is the largest medical specialty organization in the United States with members in more than 172 countries worldwide.

The guidance statement was developed by ACP's Clinical Guidelines Committee, which defined average risk as females

• who do not have a personal history of breast cancer or a diagnosis of a high-risk breast lesion,
• a genetic mutation such as BRCA 1 or 2 that is known to increase risk,
• another familial breast cancer risk syndrome,
• a history of high-dose radiation therapy to the chest at a young age.

While the annual mammography has long been considered the standard, in a paper published in Annals of Internal Medicine, the ACP authors explained that the changes have been made to tackle the harms caused by false positive results and the resulting psychological distress.

The false positive results can lead to "overdiagnosis, overtreatment, additional testing, and radiation exposure, and may outweigh the uncertain benefits in this population,” said the ACP.

Also read: Breast Cancer Screening: AI May Predict Tumors Before Mammograms Can Detect Them

Mammography For Breast Cancer: What Did The Guidelines Say

• The ACP stated that all average-risk females ages 50 to 74 should receive biennial screening mammography for breast cancer.

• It urged females between the ages of 40 and 49 to discuss with their doctor their risk for breast cancer and the benefits and harms of screening.

• The guidelines stated that asymptomatic, average-risk females who are 75 years or older, or those with a limited life expectancy, can discuss stopping routine screening with their doctor.

"This is because the benefits of screening beyond age 74 are reduced or uncertain, while potential harms, such as overdiagnosis, become more likely with increasing age," it said.

• Further, for asymptomatic, average-risk females who have dense breasts, ACP advises doctors to consider supplemental digital breast tomosynthesis (DBT).

"Decisions should consider potential benefits and harms, radiation exposure, availability, patient values and preferences, and cost," the ACP said, while advising against using supplemental MRI or ultrasound for screening in this population.

Why Experts Are Disagreeing

Breast cancer is one of the leading causes of death in 40–49-year-old women in the United States, and screening is specifically performed to prevent death from breast cancer.

Screening only women ages 50-74 every other year – as called for by ACP – may result in up to 10,000 additional, and unnecessary, breast cancer deaths in the United States each year, said the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) in a joint statement.

Also read: What's The Confusion! Why Most Women Don’t Know When To Start Mammogram Screenings?

Calling the new guidelines “outdated and hyperbolic information”, the statement noted that it will cause continued confusion among women.

"Thousands more women would endure extensive surgery, mastectomies, and chemotherapy for advanced cancers than if their cancers were found early by an annual mammogram,” it said.

Current guidelines from the ACR and the SBI urge women to start annual screening at age 40.

The ACR also recommends that women have a breast cancer risk assessment by age 25. Those at higher risk for breast cancer should talk to their doctor about starting screening before age 40 and additional screening methods -- particularly those with genetic mutations or a strong family history of breast cancer.

The United States Preventive Services Task Force (USPSTF) also urges starting annual screening at age 40 to save lives.

Further, the statement also called out ACP for its failure to recommend exams beyond digital breast tomosynthesis (DBT) for screening women with dense breasts. The statement said this "is also out of step with current research, which shows the need to go beyond DBT to help find cancer in these women".

Three cases of meningitis have been reported among schoolchildren in the Weymouth area in the UK, health officials said.

According to the UK Health Security Agency (UKHSA), of the three cases, two are pupils at Budmouth Academy, Weymouth, and the third attends Wey Valley Academy. The authorities have now rolled out meningitis vaccinations to young people in the region.

The latest outbreak comes after a meningitis outbreak was reported in the Kent region in March, which affected more than 30 people, leaving one sixth-form pupil and a university student dead.

Is the Weymouth Meningitis Outbreak Linked to the Kent Outbreak?

As per the UKHSA, the new cases were confirmed between 20 March and 15 April and are not linked to the deadly Kent outbreak.

The two pupils at Budmouth Academy are contacts of each other, but it is reportedly not epidemiologically linked with the Wey Valley Academy case.

The three cases in Weymouth have been confirmed as Meningitis B (MenB) and are the same sub-strain type, but a different sub-strain to the one detected recently in Kent.

Notably, all pupils in years 7 to 13 in Weymouth, Portland, and Chickerell are to be offered antibiotics and the MenB vaccination.

Close contacts of the cases have already been offered antibiotics as a precaution.

Will The Weymouth Meningitis Spread Further?

Also read: Meningitis claimed 259,000 lives globally in 2023: The Lancet

According to UKHSA deputy director Dr Beth Smout, "it is possible that we will see further cases linked to these latest cases in Weymouth".

He stated that the authorities are widening the "offer of antibiotics and vaccination" as "an additional precaution" to reduce the risk of the infection spreading.

"School pupils and staff should attend school as normal if they remain well," the official said.

What Is Meningitis?

Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered one of the classic symptoms of meningitis.

It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.

Symptoms Of Meningitis

Also read: Unique Symptoms Of Meningitis That Caused An Outbreak In Kent University

Smout urged everyone to be alert to the signs and symptoms of meningococcal meningitis. Common symptoms of meningitis

• Rash
• Headaches
• Neck stiffness
• Fever
• Drowsiness
• Nausea or vomiting
• Increased sensitivity to light.

"If the disease is suspected, you should seek immediate medical attention as the disease can progress rapidly," Smout said.

"The most important short-term thing and the quickest way for people to protect themselves is the antibiotic.

"The vaccine offers longer-term protection. There are two doses, four to six weeks apart, and you are only protected after the second dose," the official said.

A 2026 target trial emulation has found that glucagon-like peptide, also known as GLP-1, which is used by type-2 diabetes patients, can raise the risk of suffering from erectile dysfunction. According to a report published in the European Medical Journal, the impact of GLP-1s on sexual health outcomes in diabetic men has been inconsistent and limited. Erectile dysfunction, however, has been a prominent complication affecting 50 per cent of men with type-2 diabetes over their lifetime.

The effect of GLP-1 on men with type-2 diabetes

For this, researchers analysed the electronic health records of men aged 18 years and above with type-2 diabetes in the US from January 2019 to September 2024. Participants were started on treatment with either dipeptidyl peptidase-4 inhibitors (DPP4i) or GLP-1, with 5,524 and 4,910 individuals, respectively. Men with a history of erectile dysfunction diagnosis or end-stage renal disease were not part of the study population. The mean age of these men was 63 years, and the average BMI was 32.8—55 per cent of participants were White, and 23 per cent were Black. GLP-1 users were younger and had a higher prevalence of obesity compared to DPP4i users.

Higher rate of erectile dysfunction

Experts involved in the study found that the incidence of erectile dysfunction in the GLP-1 group was about 35 cases per 1,000 person-years. In the case of DPP4i users, the number dropped to 28 per 1,000 person-years. Hence, people in the GLP-1 cohort had a 26 per cent higher risk of developing erectile dysfunction over a three-year follow-up period. Results were consistent across subgroups; however, they lacked statistical significance after adjustment for negative outcomes.

Can GLP-1 cause erectile dysfunction?

Researchers noted that the findings of the target trial emulation suggest that sexual health outcomes must be considered in diabetic men, especially those dealing with type-2 diabetes and undergoing treatment with GLP-1 drugs. These findings also highlight the need for randomised trials with standardised erectile dysfunction assessments to further investigate biological pathways.

What complications does type-2 diabetes cause in men?

Type-2 diabetes can cause the following complications in men:

1. Heart disease
2. Stroke
3. Erectile dysfunction
4. Kidney disease
5. Retrograde ejaculation
6. Lower testosterone levels
7. Urinary retention or frequent urination
8. Vision loss—diabetic retinopathy