A single and inexpensive Polypill could cut heart attacks and strokes up to 40%, study finds

In what some researchers are calling a "transformational approach to preventing heart disease," an inexpensive Polypill, along with an aspirin, cut heart attacks and strokes by up to 40%, according to 'The International Polycap Study (TIPS-3)" published in the New England Journal of Medicine. The research was also presented at the American Heart Association Scientific Sessions on Friday, 13 November.

For more than a decade, doctors have been testing whether the cheap, all-in-one combo pills could make it easier to prevent heart disease, the top killer worldwide. The results show their value — and not just for poor nations. The study was funded by the Wellcome Trust, a British charity that supports research; Cadila Pharmaceuticals; and other public and private research organisations.

A Polypill is a medicine that combines three different blood pressure medications (atenolol, ramipril, and the "water pill" hydrochlorothiazide) and a cholesterol-lowering statin medication simvastatin. These are all generic drugs. Polypills can be taken alone or with an aspirin.

Researchers enrolled more than 5,700 volunteers, primarily in India and the Philippines plus Colombia,Canada, Malaysia, Indonesia, Bangladesh, Tanzania and Tunisia. Eminence Associates for Social Development, a non-government health research based organisation was the implementer of this research in Bangladesh. Public Health reseacher Dr Shamim Hyder Talukder and also Dr Shahin Akhter lead the Bangladesh research team on behalf of Eminence.

This study was to have run for five years and to have included 7,000 people, but drug delivery problems and the coronavirus pandemic forced researchers to cut it short. After just over four years on average, aspirin alone did not make a significant difference, and the polypill alone showed a trend toward modest benefit.

Men had to be at least 50 years old and women at least 55 for this study.All of the volunteers were considered to have a moderate risk for heart problems due to underlying conditions like diabetes or high blood pressure.Researchers followed the volunteers for nearly five years.The volunteers were divided into groups and given either low-dose aspirin (75 milligrams), the Polypill alone, the Polypill plus aspirin or placebo pills. One group was assigned to get vitamin D, but those results are not available yet. Neither the participants nor their doctors knew who was taking what until the study ended.

The Polypill with the aspirin reduced heart problems and deaths by 31% and came with minimal side effects. About 1.5% more of the polypill users had dizziness or low blood pressure, but they could be switched to a lower dose if that happened. Those who continued to take the pill without interruption show 40% reduced risk of heart problems. Only about 4% in the group that took the Polypill and aspirin had a heart problem like a stroke or heart attack or another heart problem tracked by this study or died, compared to the nearly 6% who did in the placebo group.

"We could save millions of people from experiencing serious heart disease or stroke each year with effective use of the Polypill and aspirin," said SalimYusuf, Principal Investigator for the study and a professor of medicine at McMaster University in Canada, in a news release.