Combination pharmacotherapy for cardiovascular disease prevention: threat or opportunity for public health?

In a series of three papers in the British Medical Journal (June 28, 2003), Wald et al. proposed that the Polypill can reduce the incidence of coronary heart disease by 88%, and stroke by 80%, if taken by all people aged > or = 55, as well as people of any age with existing cardiovascular disease or diabetes. We review the rationale and uniqueness behind this idea, identify the concerns and questions that need to be addressed, discuss whether this strategy is a threat or an opportunity for public health, and hope that this will stimulate further debate.