Небольшие дозы нескольких препаратов снижают побочные эффекты и сохраняют преимущества Полипилла. Часть 3. 14

Небольшие дозы нескольких препаратов снижают побочные эффекты и сохраняют преимущества Полипилла. Часть 3. 14

Can we help?

But the idea is what we talked about before. If you give small doses of a variety of medications that have benefits on their own, you could maybe have a lower rate of side effects or maybe no side effects and have dramatic benefits. Dr. David Ellison, MD.: And so typically the polypill will have a statin and maybe some polypill used to have aspirin in it, and a little bit of an ACE inhibitor or Angiotensin Receptor Blocker, and then a little bit of a thiazide diuretic. All these drugs that we know to improve outcomes in patients when drugs are used to full doses. But one of the problems with using any of these classes of drugs, is that it elicits a physiologic counter-response that can be adverse. So, you may give a diuretic that stimulates the renin - angiotensin aldosterone system. We talked about the fact that angiotensin and aldosterone can be bad actors, they can hurt you. Dr. David Ellison, MD.: And so, you think that by stimulating the renin angiotensin - aldosterone system that might have adverse effects. Well, we think that the benefits outweigh the risks when you give a thiazide diuretic. Conversely, when you inhibit the renin - angiotensin system and lower blood pressure, you can sometimes tend to accumulate fluid, and that's a bad thing. So, in theory, if you block multiple points along the pathway, you might be able to get all the good effects without the bad. By using very low doses, you are likely to avoid most of the side effects. I actually am very enthusiastic about polypill. I think that the data about the polypill is very exciting. Whether this should be given broadly to people in other countries like the United States or in Europe, at this point, there's not enough enthusiasm for doing that. But I think it's been more inertia than it's been based on scientific data. And if I could counsel people that I know, if it were available in this country, I might suggest they do it.