PARIS, Aug 23, 2019 (BSS/AFP) – A cheap, once-a-day pill combining aspirin
with drugs that lower blood pressure and cholesterol cuts the risk of major
heart failure and stroke by a third, researchers said Friday.
In clinical trials, the so-called “polypill” was especially effective among
people with no history of cardiovascular disease, reducing the number of
severe events by 40 percent, they reported in The Lancet, a medical journal.
In patients with a history of heart problems and strokes, the drug combo
was only half as effective compared to the control group, who received advice
on healthy living but no drugs.
The polypill concept was first proposed more than 20 years ago as a
simpler, cost-effective approach to treating cardiovascular disease, which
often requires taking several medications.
Up to now, patients are typically prescribed one or more drugs to lower
blood pressure along with a statin, which holds lipids such as fatty acids in
check. Aspirin, an analgesic, has blood thinning properties.
“The more tablets people have to take, the less they comply in the long-
term,” noted Kausik Ray, a professor in public health and Imperial College
London not involved in the study.
“For chronic diseases, this is a challenge as you are asking people to take
multiple medications every day for 30 or 40 years.”
About a third of patients stop taking their meds as early as 90 days after
a heart attack, according to earlier research.
But despite its obvious potential, the polypill had yet to be tested on a
large number of people over a long period of time.
Scientists led by Reza Malekzadeh from the Tehran University of Medical
Sciences recruited nearly 7,000 men and women, aged 50 to 75, living in rural
Golestan, a province in Iran.
– Take your meds –
About one in ten had previously had heart attacks, strokes or other
cardiovascular episodes.
The participants were divided into two groups of roughly the same size. One
was given “lifestyle advice” only, while the other also got a daily polypill
from 2011 to 2013.
Doctors monitored compliance with the drug regimen, and then tallied the
number of strokes and heart attacks across each cohort over the next five
years.
Crucially, adherence was significantly higher with the all-in-one pill.
“Drugs do not work if they are not taken,” noted Amitava Banerjee, a
consultant cardiologist at University College London.
Compared with the lifestyle group, the polypill cohort had 34 percent fewer
adverse events. Results were similar for men and women.
Blood pressure did not differ much, but “bad” (LDL) cholesterol levels were
lower in the group taking meds.
“Now we know that a fixed-dose polypill can achieve clinical benefits in
practice,” Malekzadeh said in a statement.
“But the polypill is not an alternative to a healthy lifestyle and should
be combined with physical activity, a healthy diet, and smoking cessation.”
Other researchers not involved in the study said the findings could be a
game changer, especially in developing nations.
“Given the polypill’s affordability, there is considerable potential to
improve cardiovascular health and to prevent the world’s leading cause of
death,” noted co-author Nizal Sarrafzadegan, a researcher at Isfahan
University of Medical Sciences.
“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.”