A new study of the polypill has shown large reductions in blood pressure and cholesterol levels, which if maintained long-term could translate into a substantial cut in heart attacks and strokes, the authors claim.
For UK healthcare professionals only
The study, published on July 18 in PLoS One, was conducted by Dr David Wald (Wolfson Institute of Preventive Medicine, London) and colleagues. The polypill used contained three antihypertensive medications – the calcium antagonist, amlodipine 2.5 mg; the angiotensin-receptor blocker, losartan 25 mg; and the diuretic, hydrochlorothiazide 12.5 mg – in addition to the cholesterol-lowering agent simvastatin 40 mg.
In the study, 86 individuals were randomised to the polypill or placebo for 12 weeks. They then crossed over and took the other treatment.
Mean systolic blood pressure was reduced by 17.9 mmHg, diastolic pressure was reduced by 9.8 mmHg, and low-density lipoprotein (LDL) decreased by 1.4 mmol/L. Although the trial was too short to assess the impact on cardiovascular events, sustained reductions in blood pressure and cholesterol of this magnitude would reduce ischaemic heart disease events by 72% and stroke by 64%, the authors estimate.
Side effects occurred in 29% of those on the polypill compared with 13% on placebo, although none were serious enough to cause discontinuation.
Dr Wald’s group are positioning their polypill as a universal medication to be taken by everyone over a certain age – roughly 50 or 55 years. Other groups are developing different formulations for both primary- and secondary-prevention populations.