Study shows daily 'polypill' reduces heart disease, stroke

Henrietta Strickland
August 25, 2019

The "polypill" contains four different drugs, including blood-thinning aspirin and a cholesterol-lowering statin.

PolyIran included Iranian men and women aged over 50, 90% of whom had no cardiovascular disease at the start of the five-year study, which was led by investigators at Tehran University of Medical Sciences.

A combination of four medications in one pill may provide a less expensive option for people to avoid life-threatening heart problems, new research shows.

Newly published results of a clinical trial into the "polypill" are said to demonstrate for the first time its effectiveness in preventing cardiovascular disease.

Writing in the Lancet, researchers from the UK, US and Iran reported that 3,417 people were given only minimum care, such as help with controlling blood pressure or cholesterol if needed, as well as lifestyle advice on topics such as diet, exercise and smoking. Researchers said the study could be a gamechanger, especially in poor countries and for people who don't stick to a multi-tablet regimen.

In terms of risk reduction, we can see the people who benefit most are those with high adherence. Roughly half of the subjects were given the polypill and advice on how to improve their lifestyle in order to promote heart health, and the rest were simply given the lifestyle advice.

"For chronic diseases, this is a challenge as you are asking people to take multiple medications every day for 30 or 40 years".

The idea of combining several drugs in a single pill was originally proposed in 2001.

"Over three-quarters of the people of the 18 million people who die from cardiovascular diseases each year live in low and middle-income countries". Both groups showed similar low levels of problematic events including internal bleeding and peptic ulcers. After adjusting for participants taking other cardiovascular drugs, the overall protective effect of the polypill was reduced to 22% (from 34%) but remained statistically significant.

The research was carried out in a collaboration between the University of Birmingham, Tehran University of Medical Sciences in Iran, Golestan University of Medical Sciences in Iran, Morgan State University in the USA, Isfahan University of Medical Sciences in Iran, Icahn School of Medicine in the U.S. and the National Cancer Institute also in the US.

"Polypills are commercially available in a number of countries for secondary prevention, but this is the largest trial confirming the value of the polypill and showing it is effective in primary prevention", says co-author Professor Tom Marshall from University of Birmingham in the UK.

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