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.

GLP-1 drugs such as Ozempic and Wegovy can reduce cardiovascular events and deaths in people with type 2 diabetes (T2D) and some people with obesity. However, stopping treatment may affect these benefits.

Around 20–50% of patients discontinue GLP-1 therapy within the first year. Previous studies have linked discontinuation to weight regain and worsening blood sugar, blood pressure and cholesterol levels.

Now, a study published in The Lancet Regional Health has found that people with type 2 diabetes and no previous cardiovascular disease who stopped GLP-1 treatment had nearly twice the risk of heart attack, stroke or death from any cause compared with those who continued.

"In people with T2D and without previous cardiovascular disease, interrupting a therapy with GLP-1RA was associated with a higher risk of a composite of myocardial infarction, stroke, or death from any cause compared to those continuing the treatment," said researchers from IRCCS MultiMedica in Milan, Italy.

However, the observational study cannot establish that stopping GLP-1 drugs directly caused the increased risk. Researchers also did not know why patients discontinued treatment, which could have been due to side effects, cost or underlying illnesses such as frailty or cancer.

What Did The Study Find?

Researchers analysed electronic medical records from more than 300 diabetes clinics in the Italian Association of Clinical Diabetologists (AMD) database, covering 2004–2024.

They identified more than 80,000 people with type 2 diabetes and no established cardiovascular disease who had started GLP-1 treatment.

Those who continued treatment took the medication for nearly three years on average, compared with just over one year among those who stopped.

The combined risk of non-fatal heart attack, non-fatal stroke or death from any cause was nearly twice as high among those who discontinued treatment.

• Those who stopped: About 4 events per 100 people per year.
• Those who continued: About 2 events per 100 people per year.

People With Obesity Had Higher Risks

Among those who discontinued treatment, the risks of adverse outcomes were higher in people with obesity (body mass index of 30 or above) than in those without obesity.

Interestingly, changes in weight, blood sugar and blood pressure after stopping treatment were modest and similar among those who subsequently experienced a heart attack, stroke or death and those who did not.

This suggests that changes in these risk factors may not fully explain the higher rates of adverse outcomes.

Should You Stop Ozempic Or Wegovy?

Lead author Antonio Ceriello, head of diabetes research at IRCCS MultiMedica, said the association between stopping GLP-1 receptor agonists and poorer cardiovascular outcomes was "not a complete surprise". However, he noted that the scale of the association was significant, ABC News reported.

The researchers said long-term GLP-1 use may be important for maintaining health benefits in people with type 2 diabetes, but further studies are needed to establish whether stopping treatment directly increases cardiovascular risk or reflects worsening underlying health.

People taking Ozempic, Wegovy or other GLP-1 medications should discuss any decision to stop treatment with their doctor.

Eli Lilly's oral weight-loss drug Foundayo, that received FDA approval in April 2026, has shown promise in reducing the severity of obstructive sleep apnoea (OSA) in a recent trial.

OSA is a condition in which breathing repeatedly gets interrupted during sleep. In a late-stage clinical trial, the medicine reduced the repeated starting and stopping of breathing by up to 44% over 52 weeks in adults with moderate-to-severe sleep apnoea and overweight or obesity.

The findings from the phase 3 ATTAIN-OSA clinical programme were presented at the American Heart Association's Scientific Sessions 2026 on November 9 and published simultaneously in JAMA. The study included 712 participants, divided into two groups based on whether they were using positive airway pressure (PAP) therapy.

Eli Lilly plans to submit the findings to the US Food and Drug Administration (FDA) by the end of 2026 to seek approval for Foundayo as a treatment for moderate-to-severe obstructive sleep apnoea in adults with overweight or obesity.

Foundayo Reduces Sleep Apnoea Episodes

Also read: Lancet Study Says Obesity Drug Mazdutide Shows 18% Weight Loss In 32 Weeks: How Does It Compare To Wegovy?

The trial evaluated Foundayo, also known by its generic name orforglipron, in two separate studies. One involved 363 adults who were not using PAP therapy, while the other included 349 participants who continued using it.

After 52 weeks, the drug reduced the number of breathing interruptions per hour, measured using the apnoea-hypopnoea index (AHI).

The findings included:

• Participants not using PAP therapy: Breathing interruptions fell by 43.8% compared to a 6.3% reduction in the placebo group.
• Participants using PAP therapy: Breathing interruptions fell by 27.5% compared to a 3% reduction in the placebo group.
• Better oxygen levels: Sleep apnoea-related oxygen deprivation, measured through hypoxic burden, fell by 55.9% in the group not using PAP and 45.8% in the group using PAP.

The drug also helped some participants reach remission or mild disease. According to Lilly's reported efficacy analysis, this included 31.5% of participants not using PAP therapy and 19.6% of those using it.

Can Foundayo Replace CPAP Therapy?

Also read: Ozempic, Mounjaro Users Report Burning Skin Sensation: What Is Allodynia?

Continuous positive airway pressure (CPAP), a form of PAP therapy, remains a standard treatment for obstructive sleep apnoea. It uses a machine to deliver a steady flow of air through a mask, keeping the airway open during sleep.

The ATTAIN-OSA programme included participants who were not using PAP therapy as well as those who continued using it. The results suggest that Foundayo could benefit both groups, but they do not establish that patients can stop using CPAP.

Vaishnavi Kundel, the study's presenting author and Associate Professor of Medicine at the Icahn School of Medicine at Mount Sinai, said, “If approved to treat obstructive sleep apnea, orforglipron could be a promising oral pharmacologic option for people with overweight or obesity and this condition. A convenient daily pill may help expand access to treatment for sleep apnea, and it could potentially be used with CPAP or other therapies to better meet individual patient’s needs.”

More About Foundayo

Also read: Ozempic, Zepbound: US FDA Orders New Warning Over Rare Eye Risk

Foundayo is an oral glucagon-like peptide-1 (GLP-1) receptor agonist. It is taken once daily and works by mimicking the GLP-1 hormone, which helps regulate appetite, calorie intake and blood glucose levels.

By reducing appetite and supporting weight loss, the drug may help address one of the important risk factors of obstructive sleep apnoea.

Excess weight, especially around the neck and upper airway, can increase the likelihood of airway narrowing or collapse during sleep. When the airway repeatedly becomes blocked, breathing interruptions occur and blood oxygen levels can fall.

Participants taking Foundayo lost an average of 11.5% of their body weight in the study group not using PAP therapy and 11.2% in the group using it.

Why Is Obstructive Sleep Apnoea A Concern?

Obstructive sleep apnoea is a breathing disorder related to sleep in which the muscles and soft tissues of the upper airway relax during sleep, causing the airway to narrow or become temporarily blocked.

This results in repeated pauses in breathing or episodes of shallow breathing, disrupting sleep and reducing oxygen levels. Common symptoms include:

• Loud and constant snoring
• Episodes of gasping or choking during sleep
• Waking up frequently during the night
• Morning headaches
• Excessive daytime sleepiness
• Difficulty concentrating and irritability

Amid increasing reports of a rare form of sudden vision loss called nonarteritic anterior ischemic optic neuropathy (NAION) following the use of drugs such as Ozempic, Wegovy and Mounjaro, the U.S. Food and Drug Administration (FDA) has ordered GLP-1 drugmakers Novo Nordisk and Eli Lilly to add warnings about the potential eye risk to their drug labels.

NAION can cause sudden, painless vision loss in one eye and, in some cases, permanent impairment.

In a Drug Safety Communication, the FDA informed patients and healthcare providers about the potential increased risk associated with these medicines. It is requiring manufacturers to include information about NAION in the Warnings and Precautions section of their drug labels.

The agency said it evaluated clinical trial data, animal studies and post-marketing evidence, including observational studies and case reports.

GLP-1 Users File Lawsuits Over Vision Loss

Also read: Hundreds Of American GLP-1 Users Sue Novo Nordisk, Eli Lilly Over Vision Loss: What Is NAION?

The FDA action comes amid lawsuits filed by people who allege they developed NAION after taking GLP-1 drugs such as Ozempic and Wegovy.

According to The Wall Street Journal, US law firm Weitz & Luxenberg has filed more than 90 lawsuits in New Jersey state court since 2025 on behalf of people who say they developed the condition while taking these medicines.

Separate federal lawsuits in Philadelphia accuse Novo Nordisk and Eli Lilly of failing to provide adequate warnings about the potential eye risk. The cases are pending. The allegations do not establish that the medicines caused the condition.

Regulators in Europe and Australia have also required warnings about a possible increased risk of NAION with some GLP-1 medicines.

In the US, vision problems are listed as possible side effects, but NAION had not previously been included as a specific risk in FDA-required labelling. The FDA's Sentinel Initiative is also reviewing the possible safety signal.

What Is NAION?

NAION is the most common acute optic neuropathy in people over 50, according to the Mayo Clinic. It occurs when blood flow to the optic nerve is reduced, damaging the nerve that carries visual information from the eye to the brain.

The condition typically causes sudden, painless vision loss in one eye. While some patients may experience partial improvement, the damage can be permanent. There is currently no proven treatment to reverse the vision loss.

Diabetes itself increases the risk of NAION, independent of GLP-1 use. Other risk factors include low blood pressure during sleep and having a small optic nerve cup.

What Does Research Say About The Risk?

Read More: Wegovy More Likely To Cause Rare Blindness Than Ozempic And Other Similar Drugs, Recent Study Finds

The potential association between GLP-1 medicines and NAION has been under regulatory review internationally.

Last year, the European Medicines Agency's safety committee said NAION may affect up to one in 10,000 people taking semaglutide for at least one year. Semaglutide is the active ingredient in Ozempic, Wegovy and Rybelsus.

The Danish Patient Compensation Association also granted compensation to four patients who experienced vision loss after using Novo Nordisk's GLP-1 medicines.

A large study published in 2025 tracked nearly 175,000 people with diabetes taking semaglutide and an equal number taking non-GLP-1 medicines. It found that the risk of NAION was more than twice as high after two years of treatment with semaglutide compared with other diabetes medicines.

However, an observed association does not establish that the medicines directly caused the condition.

The FDA routinely monitors medicines after they enter the market, evaluates potential safety signals and takes regulatory action when appropriate.