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 sudden collapse and death of a nine-year-old girl inside her Delhi classroom following a cardiac arrest has raised concerns about sudden cardiac emergencies in children. The Class 3 student reportedly collapsed shortly after returning to the classroom from a games period.

CCTV footage showed her entering the classroom, holding her waist and falling to the floor. A teacher rushed to help her, while school staff took her to a nearby hospital. She was subsequently taken to another hospital in Nirman Vihar, where doctors declared her dead.

Speaking to HealthandMe, Dr Neeraj Awasthy, Senior Director, Pediatric Cardiology, Fortis Hospital, Okhla, said the heart condition in children are extremely rare and differ from those in adults.

"In adults, a heart attack is usually caused by a blockage in the arteries supplying the heart. In children, sudden cardiac arrest is more often associated with an underlying heart condition, such as a structural abnormality, an inherited problem affecting the heart rhythm or inflammation of the heart muscle," he said.

What Causes Sudden Cardiac Events In Children?

Also read: Spanish Striker Jesus De Miguel Dies After On-Field Collision: Can A Blow To The Chest Trigger Cardiac Arrest?

According to Dr Awasthy, sudden cardiac arrest in children is commonly associated with structural heart abnormalities, inherited rhythm disorders and inflammation of the heart muscle.

In a post on X, Dr Sudhir Kumar, Neurologist at Apollo Hospitals, Hyderabad, identified other conditions that can trigger cardiac arrest in apparently healthy children:

• Hypertrophic cardiomyopathy.
• Long QT syndrome.
• Catecholaminergic polymorphic ventricular tachycardia (CPVT).
• Congenital coronary artery abnormalities.
• Myocarditis.

Some children may have no symptoms until a life-threatening cardiac arrhythmia occurs, he noted.

Does Genetics Contribute To Sudden Cardiac Death?

Nearly one in five sudden cardiac deaths in young people may have a definite genetic explanation, according to scientist Vinod Scaria.

In a post on X, he identified three groups of inherited conditions linked to this risk:

• Cardiac channelopathies.
• Cardiomyopathies.
• Familial hypercholesterolaemia.

An analysis of Indian genomes found variants associated with channelopathies in approximately 1% of individuals, cardiomyopathies in more than 1.5% and familial hypercholesterolaemia in about one in 150 individuals, Scaria said.

A molecular autopsy can identify genetic causes that a conventional autopsy may miss. Since many of these conditions are inherited in an autosomal dominant manner, up to half of first-degree relatives could carry the same genetic variant.

People with a family history of unexplained sudden death or inherited heart disease should seek genetic counselling.

What Warning Signs Should Parents Watch For?

Read More: Energy Drinks Linked To More Heart Problems In Young Adults: Study Flags Cardiac Risks

Dr Awasthy and Dr Kumar highlighted the following warning signs:

• Fainting during physical activity.
• Unexplained chest pain.
• Breathlessness.
• A racing heartbeat.

What Should You Do If A Child Suddenly Collapses?

Dr Kumar said immediate cardiopulmonary resuscitation (CPR) and access to an automated external defibrillator (AED) can save a child's life if they collapse and are unresponsive or not breathing normally. He also outlined the steps teachers and bystanders should take:

1. Check responsiveness and breathing: Do this for no more than 10 seconds.
2. Call emergency services: If the child is unresponsive and not breathing normally or is only gasping, call an ambulance.
3. Get an AED: Ask someone to bring one.
4. Start CPR immediately: Do not wait for the ambulance.

For a school-age child, he advised:

• Perform chest compressions at 100–120 per minute.
• Compress the chest approximately 5 cm, or one-third of its depth.
• If trained, give 30 compressions followed by two rescue breaths when performing CPR alone.
• Minimise interruptions.
• Use an AED as soon as available and follow its instructions.

How Can Schools Prepare For Cardiac Emergencies?

Dr Kumar recommended that schools:

• Train all teachers and support staff in CPR and basic life support.
• Make AEDs accessible on campus.
• Establish clear emergency response protocols.
• Ensure staff know how to contact emergency services.
• Conduct regular mock drills.

An experimental gene therapy has shown tremendous potential in reducing the frequency of seizures in three patients with drug-resistant epilepsy.

The results have raised hopes for a new approach to treating epilepsy patients who do not respond to conventional anti-seizure medications.

All three participants experienced a reduction of more than 90% in their monthly seizure frequency after the treatment. No serious side effects were reported during the study.

The results were reported today in The New England Journal of Medicine by Yang Dai, a neurosurgeon at Xuanwu Hospital of Capital Medical University in Beijing, and his colleagues.

“It’s exciting that there’s such a dramatic effect, and that they see very few side effects,” says Matthew Walker, a neurologist at University College London who was not associated with the study.

How Does the Experimental Gene Therapy Work?

Also read: TV Actor Anuj Thakur Dies At 33 After Suffering A Seizure In His Sleep: When Can Nocturnal Seizures Turn Fatal

The treatment uses a modified virus called adeno-associated virus 9 (AAV9) to deliver genetic instructions directly into the part of the brain from where seizures stem.

The virus carries a gene that instructs specific neurons, known as excitatory neurons, to produce a receptor that are sensitive to a particular medication.

Once the gene is delivered, patients take clozapine, which is an antipsychotic medication. The drug activates the receptors, reducing the activity of the neurons and helping suppress the electrical signals that cause seizures.

Researchers describe the medication as a kind of dimmer switch because it allows them to adjust the activity of the genetically modified brain cells.

Unlike conventional gene therapies, this approach gives researchers a way to regulate the treatment using medication.

What Did The Clinical Trial Find?

Also read: Woman With Epilepsy Dies After Following ChatGPT’s Advice To Stop Medication: Why AI Cannot Replace A Doctor

The study was led by neurosurgeon Yang Dai of Xuanwu Hospital, Capital Medical University, in Beijing.

It involved three adults with drug-resistant epilepsy caused by hippocampal sclerosis, a condition in which scarring develops in the hippocampus, a brain region involved in memory and seizure activity.

All three participants had experienced epilepsy for 10 to 25 years. Despite trying at least two anti-seizure medications, their seizures still remained out of control.

They also experienced at least two seizures per month on average during the three months before entering the trial.

After gene therapy all three participants saw a reduction of more than 90% in their monthly seizure frequency.

Significant Discovery For People With Drug-Resistant Epilepsy

Also read: Can ChatGPT Replace Your Doctor? Why Epilepsy Patients Should Never Alter Medication on AI Advice

Epilepsy is a neurological disorder characterised by recurrent seizures caused by abnormal electrical activity in the brain.

Anti-seizure medications can help many people control their seizures. However, some patients continue to experience seizures despite trying multiple medications.

This is known as drug-resistant epilepsy. According to the International League Against Epilepsy, it generally refers to a failure to achieve control of seizure after sufficient trials of two anti-seizure medications.

Surgery may be an option for patients with focal epilepsy if doctors can identify the brain region responsible for seizures.

Limitations Of The Study

The new gene therapy takes a different approach by targeting the neurons responsible for seizures.

However, experts have raised concerns about the long-term use of clozapine. High doses of the drug have been associated with cardiovascular complications and other adverse effects.

Despite the reduction in seizures, researchers have warned against interpreting the findings as proof that the treatment is effective for all people with epilepsy.

The trial involved only three participants, making it too small to probe the treatment’s long-term safety or effectiveness.

All three also had a specific form of epilepsy related to hippocampal scarring on one side of the brain. The findings cannot automatically be applied to people with other forms of epilepsy or seizures originating in different brain regions.

More than a quarter of Americans (28%) misrepresented symptoms to obtain antibiotics for themselves, while 27% did so to get antibiotics for a child in their care, according to an alarming survey.

The nationwide survey of nearly 1,000 people, published in JAMA Network Open, found that common reasons included feeling very sick, believing antibiotics were the only effective treatment and needing to recover quickly to return to work or school.

The findings highlight the need for better communication between doctors and patients so that concerns are heard and symptoms are appropriately treated, whether or not antibiotics are needed.

“Now that we have a clearer picture of how common these behaviors are and the reasons behind them, the next step is to look at strategies that help patients express their preferences and communicate what they’re feeling to their provider, and for their provider to hear them, understand their concerns, and reassure them,” said Alistair Thorpe, research assistant professor of population health sciences at the University of Utah Health and one of the study's first authors.

What Did The Survey Reveal?

Also read: AI-Created Virus Injected Into A Human For The First Time To Fight Antibiotic Resistance

Among respondents, 28% said they had deliberately exaggerated or fabricated symptoms to obtain antibiotics for themselves, while 27% had done so for a child in their care.

The most common reason was feeling that they or their child were very sick and believing antibiotics were the only treatment that could help.

“It is a tough situation,” Thorpe said. “People are experiencing unpleasant symptoms, and they can have this strong feeling that antibiotics are the only thing that can help them feel better. Being told to just rest and wait is a hard thing to do, and if you think there’s something that could make you feel better, it’s a very hard impulse to override.”

Other reasons included needing to recover quickly to return to work or school and wanting greater control over treatment decisions.

Why Is Taking Unnecessary Antibiotics Dangerous?

Antibiotics treat bacterial infections but do not work against viral infections, which commonly cause cold- and flu-like symptoms. They can also cause side effects.

“These medications are not totally benign for the patient,” explained Andrea Levy, Professor of social sciences at Connecticut State Community College Middlesex and one of the study's first authors. “And antibiotic use contributes to increasing antimicrobial resistance, which is a broader public health concern.”

Unnecessary antibiotic use contributes to antimicrobial resistance (AMR), making bacterial infections harder to treat.

Accurate symptom reporting is therefore important. Doctors need a clear picture of a patient's symptoms to determine whether antibiotics are necessary and avoid prescribing them when they are unlikely to help.

Read More: 98 Years After Penicillin: Are We Running Out Of Effective Antibiotics?

Why Are Children At High Risk With Antibiotic Misuse?

Children commonly receive antibiotics for infections such as ear infections and respiratory illnesses. However, many childhood infections are caused by viruses, against which antibiotics are ineffective.

Unnecessary antibiotic exposure can cause side effects, including diarrhoea, nausea and allergic reactions. It can also contribute to antimicrobial resistance, making future bacterial infections harder to treat.

Repeated antibiotic use may also disrupt the developing gut microbiome, which plays a role in digestion and immune function.

Why Do Patients Misrepresent Symptoms And How Can It Be Prevented?

The researchers emphasise that the findings are not intended to blame patients or caregivers.

“There are very understandable reasons that we can sympathize with about why patients might feel the need to misrepresent symptoms, or why caregivers might do so on behalf of their children,” Levy said. “We’re simply saying: perhaps there’s a better way.”

Past experiences with healthcare providers may influence these decisions. People were more likely to exaggerate symptoms if a doctor had previously dismissed or downplayed their concerns.

Another factor is the mistaken belief that antibiotics helped someone recover from an earlier viral infection. Since viral infections usually resolve on their own, patients may incorrectly attribute their recovery to antibiotics rather than the body's natural healing process, Thorpe explained.

The findings highlight the need for better communication between doctors and patients.

Healthcare providers need to reassure patients that their symptoms are being heard and taken seriously, even when antibiotics are not appropriate.