Interview - Dr Bill Glasson, AMA President, with ABC 702 Radio 'The World Today', Highfield & Hall - 'Super-pill' which could reduce the incidence of heart attack and stroke. Australian experts are warning caution about this

COMPERE: Well now to the news which has been all over the international media today about research into a super pill which could reduce the risk of heart attack and stroke.

Well, in Australia, parts of the medical community are warning to be cautious about the claims.

Researchers from the University of London conducted 750 trials on nearly half a million people, using a combination of six of the most effective compounds used to treat cardiovascular disease.

The researchers, from the Department of Environmental and Preventative Medicine, who've had their findings published in the British Medical Journal, concluded that the development of one polypill, which would combine all six drugs, would add an extra 10 years or more to the lives of around one third of people over the age of 55, as Tanya Nolan reports.

NOLAN: It sounds too good to be true - take one pill a day and live an extra 10 years or more. But that's what British researchers claim could happen after conducting widespread trials using a combination of six drugs used to treat heart disease - including those used to lower cholesterol and blood pressure, folic acid and aspirin.

Their findings, published in the British Medical Journal, show strokes were reduced by 80%, heart attacks by 88%. And so confident of their success, researcher Professor Nicholas Wald from the Wolfson Institute of Preventative Medicine in London says the combination of all those drugs into a polypill could be good news even for the healthy.

WALD: Everyone will benefit by having it. Some will benefit more than others, but all will benefit. So there's no point in saying, fine if your cholesterol is below X you don't need it. Even they would benefit.

NOLAN: The idea of a polypill to treat heart disease is being widely welcomed, and many say is not an unexpected advancement in treatment methods.

But what is creating concern is the conclusion reached by the researchers that everyone in western society is likely to be at higher risk of ailments such as cardiovascular disease therefore all could benefit from the use of such a polypill.

Dr Chris Levi is a stroke neurologist at the Hunter Medical Research Institute in New South Wales, and he sees little to be gained for those with a very low risk of heart disease.

LEVI: If you're treating a patient that's only running a half to one percent risk per year of an adverse event, then that, that 80% or 50% or 25% relative reduction in risk only accounts, as you can understand, for a fairly small risk reduction. And at a population level that's not gonna have all that much impact and all the expense and effort that goes into rolling out a therapy across millions and millions of people may, may not really be all that cost effective.

NOLAN: So you're saying that there really is no immediate benefit to those who are relatively healthy and at lower risk of developing cardiovascular disease?

LEVI: Absolutely. I think that's the key issue, and this is acknowledged in Anthony Rogers commentary on the paper that, that we need to be looking at those who are most likely to benefit - those at, who are the higher end of the risk spectrum.

And it's true to say that not all people over the age 50, 55 are actually in that boat. There are people over the age of 55 who are in that lower risk bracket and many of us feel that adopting a slightly more sophisticated approach and stratifying risk, particularly in that age group - in that younger age group - is important if you're thinking about these large scale, sort of population approaches to prevention of hearty attack and stroke.

NOLAN: Australian researchers are involved in the race to develop the polypill, a potential marketing goldmine, with heart attack and stroke accounting for 40% of all deaths nationally.

But the Australian Medical Association is among those warning against the idea that a magic pill can alone fix such a serious condition. And federal president Dr Bill Glasson says society needs to weigh up all the costs.

GLASSON: If in reality you can take one tablet instead of three to treat your high blood pressure and treat your and to thin your blood, that needs to be congratulated.

Obviously we need to see the appropriate trials put in place to make sure that the, this actually works. Make sure there's a, side-effect profiles aren't any worse, and if it proves to be positive then I think we need to get behind it.

NOLAN: Do you have any scepticism about the idea that this may just be generating good publicity for the imminent development of such a polypill?

GLASSON: Yeah I mean there's big money in these drugs. As you know the statins under the PBS sort of subsidy, cost us, you know, a fortune each year. And obviously no doubt we'll have to subsidise the new magic pill as well, so it's at a significant cost to the community, but a lot of people argue we've got to balance that with the costs of people having heart attacks and strokes, and I agree with that.

But the reality is that each, if each and every one of us actually ensured that we, you know, exercise appropriately and have an appropriate diet, and also had appropriate relaxation etcetera - we live in a very stressful sort of lifestyle these days - and a lot of us wouldn't necessarily develop these conditions in the first place.

But my concern is that people swallow the pill and still eat their sort of cream pies and still do little in the way of exercise. It's gotta be a balance, and that's my, I suppose the message I want to try and get out there.

COMPERE: Some words of warning there from Dr Bill Glasson who's the federal president of The Australian Medical Association, and he was speaking there to Tanya Nolan.

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