Miraculous ‘polypill’ – made from 3 drugs – may lower risk of heart diseases

Older heart disease patients who took a combination "polypill" made up of three different medications had a lower risk of major cardiovascular events, finds a new study.

The study, published in the New England Journal of Medicine, showed that "polypill" effectively prevents secondary adverse cardiovascular events in people who have previously had a heart attack,  reducing cardiovascular mortality by 33 per cent in this patient population.

"The polypill, being a very simple strategy that combines three essential treatments for this type of patient, has proved it's worth because the improved adherence means that these patients are receiving better treatment and therefore have a lower risk of recurrent cardiovascular events," said researcher Jose Maria Castellano from Fundacion de Investigacion HM Hospitales.

For the study, presented at the European Society of Cardiology Congress in Spain, the team looked at 2,499 patients in seven European countries who had a history of type 1 myocardial infarction in the past six months and were either over the age of 75 or a minimum age of 65 with at least one risk factor, such as diabetes or mild or moderate kidney dysfunction.

The average age of the participants was 76 years, and 31 per cent were women.

The study population included 77.9 per cent with hypertension, 57.4 per cent with diabetes, and 51.3 per cent with a history of smoking tobacco.

Researchers analysed the incidence of four major cardiovascular events: death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke, and the need for emergency coronary revascularization (the restoration of blood flow through a blocked coronary artery).

The study followed patients for an average of three years and produced conclusive results: patients taking the CNIC polypills had a 24 per cent lower risk of these four events than patients taking the three separate drugs.

The findings showed a relative reduction of 33 per cent, from 71 patients in the group receiving standard treatment to just 48 in the polypill group.

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All-in-one polypill to treat blood pressure and cholesterol levels ‘slashes risk of heart attack by 25%’

A “polypill” packed with four different medications to treat high blood pressure and high cholesterol is more effective at lowering the risk of heart disease than taking the medicines separately, according to a new study.

Research also found that patients – mainly those with low socioeconomic status – were likely to stick to their medication routine if it involved taking a single pill.

The team, based in the US, examined 303 patients at a community health centre in Alabama, where 96 per cent of the participants were black, 60 per cent  were women, and the average age was 56.
Three out of four participants were reported to earn less than $15,000 (£11,000) a year.

Half of the patients were given a daily polypill made up of four low-dose medications containing atorvastatin (10mg) – to treat cholesterol, along with amlodipine (2.5 mg), losartan (25 mg) and hydrochlorothiazide (12.5 mg) – to reduce high blood pressure.

The rest of the participants received their usual medical care and medications.

The patients underwent medical exams where their blood pressure and blood cholesterol levels were measured at the start of the study, with follow-up tests at two months and 12 months.

Those taking the polypill recorded higher reductions in systolic blood pressure – the amount of pressure in arteries during the contraction of heart muscle – compared with those in the usual care group.

For a normal reading, the blood pressure needs to show a top number (systolic pressure) between 90 and less than 120 and a bottom number (diastolic pressure) between 60 and less than 80. Readings are expressed in millimetres of mercury (mm Hg).

Those in the polypill group also saw a drop in their LDL (low-density lipoproteins) cholesterol – also known as “bad” cholesterol because it causes fatty buildups in arteries – compared with participants in the care group.

Cholesterol levels in the US are measured in milligrams (mg) of cholesterol per decilitre (dL) of blood.

The systolic blood pressure in the polypill group fell an average 9mm Hg in one year, compared with 2mm Hg in the care group.

In the polypill group, LDL cholesterol fell an average of 15mg per decilitre compared with 4mg per decilitre in the usual care group.

These results translate to about a 25 per cent reduction in the risk of experiencing a cardiovascular event such as a heart attack, according to study author.

He said 86 per cent of patients in the polypill group continued to take their medication over the study period, compared with past studies that found fewer than half of patients were still on their prescribed blood pressure medicines at one year.

The author said: “When it comes to preventing cardiovascular disease, simple strategies like the polypill may offer key advantages for patients who face barriers to accessing medical care.”

He said underserved patients at community health centres tend to be understudied in clinical trials.

“We need to better understand what works and what doesn’t in these settings so we can improve outcomes for people who may be the most vulnerable,” he added.

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