Polypill: For Pollyanna

A single pill containing a statin, thiazide diuretic, beta-blocker, angiotensin receptor antagonist, folate and ASA has been proposed for all people over age 55, with the aim of reducing cardiovascular disease by 80%. Unfortunately, there are insurmountable problems with choosing appropriate constituents of any such single remedy. Adverse effects, drug interactions, inter-individual variation in drug metabolism, and underlying causes of hypertension that differ between patients require individualized therapy. A single pill that will succeed in all patients is not only practically, but conceptually, an inappropriate approach for the prevention of cardiovascular disease.