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This Daily ‘Polypill’ Reduces The Risk Of Heart Attack And Stroke – Study

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A cheap, once-a-day polypill combining aspirin with drugs that lower blood pressure and cholesterol cuts cardiovascular disease as a whole by a third, and heart attacks by more than half. Researchers released this information on Friday, 23rd August 2019, in The Lancet, a medical journal.

 

In clinical trials, the so-called “polypill” was especially effective among people with no history of cardiovascular disease. This then the number of severe events by 40%.

 

For those with a history of heart problems and strokes, the drug combo was only half as effective compared to the control group. The control group received advice on healthy living but no drugs.

 

Among participants who took the pill as directed — at least 70% of the time — heart attack incidence declined by 57%.

 

The polypill concept was first proposed more than 20 years ago. It was proposed as a simpler, cost-effective approach to treating cardiovascular disease, which often requires taking several medications.

 

Currently, doctors typically prescribe one or more drugs to patients 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. Ray, a professor in public health and Imperial College London, had no involvement 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.”

 

polypill
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About a third of patients stop taking their meds as early as 90 days after a heart attack. But despite its obvious potential, researchers were yet to test the polypill 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. They were between ages 50 to 75 and lived in rural Golestan, a province in Iran.

 

Take your meds

About one in 10 had previously had heart attacks, strokes or other cardiovascular episodes.

 

The researchers divided the participants into two groups of roughly the same size. One received “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.

 

Photo: CBS News

 

“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% 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 [it] 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.

 

Co-author Nizal Sarrafzadegan, a researcher at Isfahan University of Medical Sciences, noted:

“Given the polypill’s affordability, there is considerable potential to improve cardiovascular health and to prevent the world’s leading cause of death. 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.”

 

Some experts — including the authors themselves — said they needed further trials to see of the polypill would prove effective among other populations.

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