NEWS

Is a of luck for cardiac patients?

Cardiovascular diseases (CVDs) account avoidance, little advancement has been contracted heart disease, compared with for around 18 million deaths every year, made in its use globally. Also, despite 4.7% of those who took a placebo. an estimated 31% of all deaths world- having advertising endorsements in One of the reasons that high blood wide. Over 75% of deaths are in low- or about 40 nations around the world, the pressure and high cholesterol are not middle-income countries, as they often use of CVD polypills is still restricted. treated properly is that the lack access to integrated primary health- Obstructions incorporate a doctor’s poor prescribed to treat them are not taken re- care programmes for early screening and knowledge, absence of proof on hard liably by the patients. It is likewise hard treatment of people with risk factors clinical results, and non-eligibility of to make sure to take a few drugs or dif- compared to those living in high-income government reimbursement. Another ferent dosages of prescriptions consis- countries. In India, nearly 30% of all possible block for wider use of polypills tently as they can cause side effects, and deaths and 15% of morbidities are caused is linked with worries that unfriendly can be costly as well. One potential me- by CVDs. The most important beha- impacts related to one of the polypill’s thod to improve the consistency of medi- vioural risk factors for heart diseases and parts could prompt its cessation and the cations is to combine at least one or more stroke include unhealthy diet, , deficiency of the multitude of other seg- of them in a single pill, or polypill. The harmful alcohol consumption and seden- ments’ advantages. benefits of this approach include: de- tary lifestyle. The effects of these factors Regardless of huge clinical advance- pending on the particular meds and por- can be seen in individuals as high blood ment in the prevention and treatment of tions, a polypill might be less expensive pressure, high blood sugar, high blood CVDs, the utilization of crucial drugs is than taking several individual prescrip- lipids, overweight and . Although deficient in low- and middle-income tions; lower portions of each medicine they are normal and treatable, they are nations. The use of 3–4 fundamental me- might be required, conceivably decreas- generally undertreated. A large number dications can essentially lessen mortality ing the rate of bothering results; several of lives can be saved every year if more related to CVDs, particularly in auxiliary low-portion medications can be more individuals with the above medical con- anticipation. The remaining blocks powerful than higher doses of one medi- ditions get proper treatment. However, in include low levels of investment by cation; fewer doses are simpler to recall, most cases, the conditions go unnoticed pharmaceutical companies, uncertainty and fewer pills and lower portions of for long as they usually cause no symp- related to intellectual property rights, and prescription may reduce the number of toms. Presently, as indicated by a study manufacturing and regulatory issues. emergency clinic visits, blood tests and introduced at the American Heart Asso- TIPS-3 involved about 5700 volun- other observing measures. ciation’s Scientific Sessions 2020, a teers from nine countries, almost half of As the potential benefits of a polypill polypill, with the addition of a daily por- whom were provided by India. Male vo- are obvious, they may be offset by its tion of may reduce cardiovascular lunteers were 50 years of age or older disadvantages which include: taking var- failure and stroke by up to 40%. The out- and female 55 or older. All of them were ious drugs, even at low dosages, may come is a feature of The International moderately at risk for heart problems be- prompt higher paces of results and if Study-3 (TIPS-3), a randomized, cause of underlying conditions such as such result comes, it could be difficult to placebo-controlled trial to test the ade- or high . While know which of the medications in the quacy of a fixed-dosage blend treatment. the formulation of polypills may vary, polypill are dependable; when consoli- A polypill is a in pill struc- those used in this study included 100 mg dated, medications may interact, causing ture that consolidates various dynamic of , 25 mg of hydrochlorothia- serious issues like extreme or lack of drug fixings. The prefix ‘poly’ signifies zide, 10 mg of and 40 mg of potency, unfavourably susceptible res- ‘various’, alluding to the variety of me- or placebo per day, aspirin ponses, or joined results; some individu- dications in a given ‘pill’. Giving indi- (75 mg) or placebo per day, and vitamin als just need a couple of prescriptions to viduals a pill containing numerous D or placebo monthly. The group was treat a sickness, and polypills may give conventional medications that forestall split into four and was invited to take one more than the perfect measure of a drug; coronary episodes was first proposed of the following each day: both polypill polypills have fixed portions of a few nearly 20 years back; however, advance- and aspirin, polypill alone, aspirin alone meds, so it may not be conceivable to ment and adoption was restricted. For or a placebo. The researchers monitored change the portion of one medicine treating CVDs, a polypill combines three them closely for nearly five years and without changing all of them. Though different blood pressure medications discovered that combining a polypill some people reported dizziness, muscle (atenolol, and rami- with aspirin provided the best benefits. pain and indigestion, these problems pril) and a cholesterol-lowering This reduced heart problems and deaths were found to be minimal and also com- medication simvastatin. Atenolol is used by 31% and people who continued to mon among those who did not take the as a for BP, hydrochloro- take the pill without interruption for pill. is a while ramipril is an about four years saw a 40% reduced risk Scaling up a worldwide polypill ACE inhibitor. Polypills can be used as of heart problems. The researchers also system could add to the World Health such or with aspirin, a blood thinning found that the polypill alone reduced risk Organization’s (WHO’s) objective of medicine. of CVDs by 21%, compared to 14% in decreasing mortality from non-trans- While numerous examinations have those who took aspirin alone. About mittable illnesses (counting CVDs) by upheld a polypill procedure for auxiliary 4.1% of those who took aspirin alone 30% by 2030 of each a financially savvy

256 CURRENT SCIENCE, VOL. 120, NO. 2, 25 JANUARY 2021 NEWS way, and would help accomplish the tar- pill, about 2–4 million unexpected being incompatibility among low and get of precaution drug inclusion at any deaths, heart failure and stroke could be high-financial status networks. A system rate 50% of the populace with indicative forestalled on a yearly basis. This could based on polypill may well benefit all CVD. The World Heart Federation be useful in ensuring the well-being of networks, but it seems reasonable to start (WHF) could unite specialists from individuals who have less access to med- with networks where requirements and around the world to improve admittance ical facilities. Later, polypills with more limitations may be more notable. Many to prescriptions for CVDs and specifical- up-to-date could additionally people are open to down-to-earth ways to ly to help a polypill procedure for aux- diminish LDL cholesterol and blood deal with improving their cardiovascular iliary avoidance of CVDs by leading pressure, and lessen the danger of CVDs well-being, including the utilization of a support exercises, backing the considera- by more than 50%. Polypill companies polypill. At any rate, realization of the tion of the polypill on the WHO Essen- would also have to look for Controllers’ current preliminaries should stimulate tial Medicines List. They can be endorsement to sell their pills in different the enormous use envisaged to contrast a accomplished by taking part in corres- nations, and those generic medication methodology based on polypills and the pondence endeavours and fitting them creators may group with large insurers to best accessible options. with other related activities; for example, offer the treatment. Also, the purpose of the new Coalition for Access to NCD giving out a polypill in financially weak Medicine and Products. networks may strike some as paternalis- It may well be assessed that if just tic. That worry should be weighed Arjun R. Krishnan, Science Writing 50% of individuals with either hyperten- against the risks of proceeding with the Fellow, Current Science. sion or diabetes are treated with a poly- current course, with extending well- e-mail: [email protected]

MEETING REPORT

Modelling atmospheric–oceanic processes for weather and climate extremes*

A rapid increase in the frequency of tainty of the atmosphere and especially note speaker of the session, presented an extreme weather events has been seen the extremes due to gaps in the proper assessment of observations and predic- over India in recent decades. Countries understanding of the processes involved. tions of extreme weather events over In- in Asia are witnessing increasing number With this vision in mind, an interna- dia, viz. tropical cyclones over the Bay of extreme weather events such as tional workshop was organized in 2019 of Bengal, severe thunderstorm and typhoons, cyclones and threats of ex- which brought together both academic lightning. He mentioned that the Hurri- acerbating these events (due to warming and operational researchers from India cane Weather Research and Forecasting climate) on mankind are looming large. and abroad to facilitate an understanding (HWRF) model system has achieved sig- The events like the recent floods over of the challenges in operational forecasts nificant improvement in track prediction, Kerala and Tamil Nadu, drought in of extreme weather events with a focus occurrence of thunderstorms over the Assam, extreme rainfall in Mumbai, etc. on atmospheric–oceanic processes in the Bay of Bengal’s basin because of higher are causing huge damage to property and tropical climate, particularly in Asia. model resolution, improved physics, as- result in loss of lives. An important step The workshop received overwhelming similation of satellite data, impact of in the short-term mitigation of weather response with around 100 submissions Doppler radar reflectivity and radar posi- extremes is that we should be able to re- from several countries (Indonesia, Ma- tion, and representation of large-scale liably predict such events well in ad- laysia, Singapore, Bangladesh, Thailand, synoptic conditions and other features. vance. The prediction of tropical weather China, Saudi Arabia and Japan), especially Muhammad Firdaus Ammar Bin Ab- is a challenge due to the inherent uncer- from research students and early career dullah (Malaysian Meteorological De- scientists. There were 42 poster presenta- partment) presented a case study of an *A report on an International Workshop on tions and about 25 oral presentations. extreme rainfall event over Kuala Lum- ‘Modelling Atmospheric–Oceanic Processes M. Rajeevan (Secretary, Ministry of pur, Malaysia, which was analysed using for Weather and Climate Extremes’, orga- Earth Sciences, Government of India) in Weather Research and Forecasting nized by the Centre for Atmospheric Sciences the inaugural address highlighted in- (WRF)-1 km model to study the impact (CAS) of Indian Institute of Technology Delhi creasing occurrences of extreme weather of terrain in shaping the synoptic factors. (IIT Delhi) in collaboration with the Asian and emphasized challenges in accurately He stressed upon the need for an enhan- Network on Climate Science and Technology predicting the same with further need to ced systematic observation network in (ANCST), during 28–29 March 2019. The augment the research efforts in this the region for improving the forecast of workshop was hosted by IIT Delhi. MAPEX 2019 is a key activity of the Special Topic direction. The first technical session on extreme events. Group on ‘Atmosphere–Ocean Interactions’ the first day of the workshop was based Aspects of seamless modelling system of ANCST. The key sponsoring organizations on challenges in operational forecasts of for weather/climate were elaborated by from Government of India included MOES, extreme weather events. U. C. Mohanty A. K. Mitra (NCMRWF, Noida). He dis- SERB and DST. (IIT Bhubaneshwar), who was the key- cussed how NCMRWF aims to have a

CURRENT SCIENCE, VOL. 120, NO. 2, 25 JANUARY 2021 257