Polypill Reduces Heart Disease Risk

Patients with high blood pressure (hypertension) and cholesterol have an increased risk of cardiovascular events.

There was a reduced risk of heart disease in patients receiving a single daily pill which contains a combination of blood pressure and cholesterol lowering medicine along with daily dose of aspirin. Aspirin prevents formation of clots.

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‘The risk for cardiovascular events was reduced by 31% by using polypill which contains blood pressure and cholesterol lowering agents like atenolol, ramipril, hydrochlorothiazide and simvastatin along with aspirin.’
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The study was published in The New England journal of Medicine.

The fixed dose-combination also called as polypill was used and its effectiveness was assessed in various cardiovascular events like - heart attack, stroke and cardiovascular death. In patients having moderate risk of cardiovascular events the benefit was assessed by using polypill alone or in combination with aspirin. The benefit of using aspirin alone was also assessed.

Clinical Trial

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The International Polycap Study (TIPS)-3 was conducted in nine countries which included 5,700 patients and the average age was 64 years and 47% were males.

The medications in polypill included atenolol 100mg (for blood pressure), ramipril 10mg (for blood pressure), hydrochlorothiazide 25mg (for blood pressure) and simvastatin 40mg (for decreasing cholesterol). The different drugs which were given to the patients included-

Aspirin 75mg daily
Polypill daily
Aspirin 75mg and polypill daily
Vitamin 5,000 IU daily

Analysis of the data

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The follow up period for the study was five years after which the participants were assessed on the basis of the first cardiovascular event like non-fatal heart attack, non-fatal stroke, heart failure or cardiovascular death. The analysis was as follows-

21% reduction in cardiovascular disease when polypill was used alone.
14% reduction in heart failure, cardiovascular death and stroke when aspirin was used alone.
31% reduction in cardiovascular events when polypill plus aspirin were used.

Salim Yusuf a co-author of the study and professor of medicine at McMaster University School of Medicine in Toronto, Canada said,“Aspirin should be prescribed with a polypill in primary prevention for patients at intermediate risk of heart disease. Our study results provide important data regarding the role of the polypill in preventing the development of heart disease."

Another Co-author Prem Pais, a professor in the division of clinical research and training at St. John's Research Institute in Bangalore, India, added, "We were also interested in evaluating if combining blood pressure and cholesterol reduction medications in a single pill would be effective for this population. This is a cost-effective strategy that could help meet global targets of reducing CVD by 30% by 2030."

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Yusuf said,“Use of a polypill plus aspirin can avert 3 - 5 million cardiovascular deaths globally. Future polypills, with newer statins, may reduce LDL cholesterol and blood pressure to a greater extent and could reduce cardiovascular disease risk greater than 50%."

Source-Medindia