The Polypill prescription.(Nick Wald thinks medication to prevent cardiovascular disease should be given to everyone older than 55)

Nick Wald's great brainstorm, which came to him a few years ago during his father-in-law's struggle with cardiovascular disease late in life, has the virtue of utter simplicity, and perhaps also its drawbacks. Watching as the old man downed the usual cocktail of heart medications, Wald, a professor of preventive medicine at the Wolfson Institute in London, realized that his father's trouble could have been averted, or at least minimized, if he'd begun his regimen years earlier. Of course, he didn't have symptoms then, but that's the point: half the population in Britain eventually develop serious heart disease. Rather than try to identify which half, why not just give the medication to everyone older than 55?

Out of that hunch came the Polypill. It would consist of six relatively inexpensive, generic components: a statin (to lower cholesterol), three different drugs to lower blood pressure, aspirin (to interfere with blood-clot formation) and folic acid (to reduce levels of circulating homocysteine, a suspected risk factor for heart disease). These are all drugs commonly prescribed for patients at risk for heart disease, and folic acid is found in multivitamins, but the idea of giving them routinely to everyone over a certain age is, as Wald and collaborator M. R. Law admit, "radical." In publishing their paper last summer, the editor of the British Medical Journal suggested the issue in which it appeared might be "the most important for 50 years."

It certainly has proved to be one of the most controversial. Critics argued that even aspirin has the potential to cause serious or even fatal side effects, such as gastric bleeding. And some British doctors seemed uneasy with the idea of a pill you give to everyone. "Let's take ...