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.

Indians are popping antacids like candies, and they are putting their hearts, kidneys and gut health at risk. Doctors from time and again have cautioned patients to not take such pills without prescriptions.

Antacids are prescribed proton pump inhibitors or PPIs, used commonly to reduce the amount of acid in the stomach and helps to treat and prevent various acid related conditions. However, in India, acidity is not treat as a symptom, but a lifestyle condition, which has made these pills so common. These over the counter access also created medical complacency, this means the availability has blurred the line between short term relief and long term therapy.

How does antacid impact your kidney health?

Repeated use is increasingly associated with acute interstitial nephritis and chronic kidney disease. What makes this dangerous is that kidney damage often develops silently, discovered only when kidney function has already deteriorated significantly.

How does antacid impact your gut health?

It also impact the gut microbiome, and causes chronic digestive problems. Stomach acid regulates gut bacteria. Suppressing it allows harmful bacteria to flourish, leading to bloating, infections, diarrhea, and conditions like small intestinal bacterial overgrowth (SIBO).

How does antacid impact your bone health?

Furthermore, regular usage of antacids could make your bones weak too. As per a 2023 study published in the journal BioMed Research International, pantoprazole cause bone loss, which could be prevented by adding octreotide.

The study analyzed the serum levels of calcium, phosphorus, and ALP before starting the treatment, and at the end of 12 weeks of treatment on pantoprazole, significant decline in calcium levels were noticed, as compared with other groups. The study also found that octreotide significantly prevented the effect of pantoprazole on the serum levels of calcium and ALP.

The study also found that pantoprazole decreased femoral bone density and femoral BMAD. Besides this, another decrease was found in the femoral bone weight and volume as well as the trabecular volume.

How does antacid impact your heart health?

Frequent heartburn is also a symptom of gastroesophageal reflux disease or GERD. This is a condition in which the valve between the stomach and the lower esophagus malfunctions and allows stomach acid to bubble up into the esophagus. This is often treated with antacid, which may mask the real problem.

Over time, untreated GERD can injure the lining of the esophagus and increase the risk of serious complications, including Barrett’s esophagus, a condition that can raise cancer risk. Also, symptoms often blamed on heartburn, such as chest pain or burning, can sometimes signal a heart attack. That’s why experts stress getting a proper medical evaluation before self-treating with antacids.

The safer alternatives are:

Famotidine (Pepcid, Calmicid, Fluxid, Mylanta AR) is a potent H2 blocker used to manage acidity and heartburn. Studies show that famotidine is not thought to raise the risk of osteoporosis.

Other options: Ranitidine (Zantac - where available, as it was withdrawn in some markets due to safety concerns) and Nizatidine are other H2 blockers.

Note: Health & Me do not encourage discontinuance of any prescribed medicine by a doctor. Before making any change in your medicine schedule, please speak to your doctor/GP.

Nasal spray warnings are given by doctors and experts as the long use of it could lead to worsening of condition. The Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days, as it contains xylometazoline or oxymetazoline. Its prolonged use can cause 'rebound congestion' or increased dependency on these sprays to breathe easily.

A recent poll, reports the Independent found out that almost six in 10 pharmacists report patients were unaware of the dangers of its extended use. Due to the increased number of flu activity, symptoms like blocked nose has increased, which has lead to a high usage of nasal spray.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

Read: Bristol Hospitals Under Severe Strain as Flu and Cold Weather Hit the Region

As ITV News reported, Charlotte Johnstone, who is 30, had been using nasal spray multiple times a day since she was seven years old. She realized that the impact of this so-called addiction has caused her anxiety and left her "dreaming about not being able to breathe". She told ITV News, “I can’t sleep without having it, I wake up and the first thing I do is have my nasal spray. I don’t like eating if I’ve got a blocked up nose, it just makes me feel claustrophobic. I wouldn’t put myself in a situation where I don’t have it. “I go through stages of losing my sense of smell. I know it’s doing something but I don’t know what. But for the sake of having a clear nose, I’ll just take it,” she said.

A spokesperson from PAGB, the consumer healthcare association representing the manufacturers of these products, said: “The patient information leaflet which accompanies all nasal decongestant sprays, includes these instructions and outlines the risks of taking the medication for longer than its indicated use. As explained on the information supplied with the nasal decongestant sprays, OTC medicines manufacturers provide comprehensive accessible information to support people to make responsible informed decisions about the right product to self-care for their self-treatable condition," reported ITV News.

Open AI launched a new ChatGPT feature in the US, called the ChatGPT Health. As of now, this is launched only in the United States, which can analyze people's medical records and give them better answers. However, it has also drawn attention of critics, who raise concerns regarding the privacy, as well as safety of diagnosis and treatment.

What Is ChatGPT Health?

As per the Open AI website, "Health is a dedicated space in ChatGPT where you can ask health and wellness questions and choose to connect your health data (like medical records and wellness apps) so responses can be grounded in that context. It is designed to support, not replace, medical care."

One can access Health from the sidebar and can ask health-related questions in a main chat. OpenAI has said that the conversations in ChatGPT Health would be stored separately to other chats and would not be used to train its AI tools. The feature will also not be used for "diagnosis or treatment".

However, Andrew Crawford, of US non-profit the Center for Democracy and Technology, as reported in the BBC said, it was "crucial" to maintain "airtight" safeguards around users' health information. "New AI health tools offer the promise of empowering patients and promoting better health outcomes, but health data is some of the most sensitive information people can share and it must be protected," Crawford said.

Why Is This Feature Being Introduced?

OpenAI notes that more than 230 million people ask its chatbot questions related to health and wellbeing, at least every week. Thus the feature is being launched, while ChatGPT Health will have "enhanced privacy to protect sensitive data".

Open AI also noted that users can connect it with third party wellness apps to get the data, for instance Apple Health, Peloton, and MyFitnessPal. These apps can provide the medical records to OpenAI's new feature to generate relevant responses.

In a blogpost, Open AI noted: "You can securely connect medical records and wellness apps to ground conversations in your own health information, so responses are more relevant and useful to you. Designed in close collaboration with physicians, ChatGPT Health helps people take a more active role in understanding and managing their health and wellness—while supporting, not replacing, care from clinicians."

Will This Feature Replace Doctors?

OpenAI claims that ChatGPT Health is not launched to replace medical care, rather to help one navigate everyday questions and understand patterns over time. OpenAI claims that the tool was developed in close collaboration with physicians.

In the last two years, OpenAI said that it was able to work with more than 260 physicians across 60 countries and dozens of specialities, who have provided feedback on model outputs more than 600,000 times.

While the feature is only launched in the United States, however, the company said that it plans to make Health available to all users on web and IOS "in the coming weeks" as the experience is refined.