How preventive medicine could be key to saving the NHS | Letters

Readers on how best to make disease prevention services effective, to ease the strains on both the health service and the economy

The call for the UK to focus on disease prevention is welcome (UK must move towards disease prevention to save economy and NHS, says expert, 23 July). Too many preventive health opportunities are missed. To be successful, preventive interventions need to reach all who stand to benefit. They should be simple and inexpensive, without unnecessary barriers to access. In general, while individualised medical intervention has a place in the treatment of disease, it is less appropriate for the prevention of disease.

The prevention of heart attacks and strokes is a major opportunity. Most heart attacks and strokes occur in people with blood pressure and blood cholesterol levels that are not regarded as raised, whereas almost all cases occur in people aged 50 and over. For more than 10 years, prevention has been possible using an inexpensive, effective and safe polypill from the age of 50, without the need to perform prior tests or measurements. Such a polypill, containing a statin and low-dose blood pressure medicines, could prevent over two-thirds of heart attacks and strokes, with nearly the full preventive effect being achieved about three years after starting treatment. The evidence for this is secure, but unfortunately access is limited to a private service that the NHS could emulate for all to benefit.