The All-in-One Pill

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One size fits all - isn't that what we all want? And at a time of exorbitant medical costs, isn't it practical that scientists have developed the mega-pill that cures all our ills and keeps us from having heart attacks and strokes? I wish it were that easy!

A new study from Canada and India published in the prestigious journal Lancetand presented at the American College of Cardiology meetings takes a look at a pill that combines aspirin, statin, and three blood pressure pills (a beta blocker, an ace inhibitor, and a diuretic) in patients with heart risk factors. The study took place over 12 weeks and showed that the ultimate combo drug continued to lower cholesterol, blood pressure, and be as well tolerated as the drugs taken alone.

Not only that, the results project out to a decreased risk of stroke by 48 percent and heart disease by 62 percent over a longer period.

The obvious advantages are in terms of patient compliance and low cost. But the disadvantages are also worth considering. As I've seen in my medical practice, for all combo pills, the problem is not knowing which pill is doing what, and if there is a side effect, which component is causing it. A patient may develop a problem and stop the pill and then refuse to take any of the drugs that make it up. Decisions like that can end up being more expensive in the long run, in terms of health care outcome.

And despite cardiac risk factors, some patients need one of these drugs and not the other. The diuretic may cause electrolyte abnormalities, dry people out, or make them urinate frequently. Not everyone tolerates this the same. Altace can cause a cough and the beta blocker may make some dizzy. In the final analysis, the "one size fits all" approach may not be as cost effective as it first appears.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of "False Alarm: The Truth About the Epidemic of Fear"and "Bird Flu: Everything You Need to Know About the Next Pandemic." Read more at