Polypill to reduce heart disease

A four-in-one combination pill can halve the predicted risk of heart disease and stroke suggests results from the world’s first international polypill trial

The once-a-day polypill contains aspirin and agents to lower blood pressure and cholesterol – all of which are prescribed separately to millions of patients and known to individually cut the risk of disease. Researchers hope that combining them into a single pill will encourage people to take medications more reliably.

The trial tested the effectiveness and tolerability of the polypill in 378 people with raised risk of cardiovascular disease – but who did not necessarily have high blood pressure or cholesterol – against a placebo.

“The results show a halving in heart disease and stroke can be expected for people taking this polypill long-term,” said Professor Anthony Rodgers of the George Institute for Global Health, who led the international consortium.

However, one in six experienced side effects – most were mild but one in 20 stopped treatment, indicating it is best targeted at those with a raised risk of disease.

The trial was conducted in the UK, Australia, Brazil, India, New Zealand, the Netherlands and the USA, with funding from the Wellcome Trust and British Heart Foundation. The UK arm of the trial was conducted at Imperial College London by Professor Simon Thorne.

“We now need to conduct larger trials to test whether these medicines are best provided in the form of a polypill or as separate medicines, and whether this combination strategy improves patient adherence to cardiovascular medication,” Thorne said.

Thorne’s team is now leading this larger trial – Use of a Multidrug Pill in Reducing cardiovascular Events or UMPIRE – in Europe and India, recruiting almost 2000 participants.

Natasha Stewart, senior cardiac nurse with The British Heart Foundation said: “While the concept of taking one pill rather than many sounds appealing, this was a small study and we’d need to see results from much larger trials to determine the validity of its potential benefits.”