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A four-in-one polypill combining three blood pressure drugs with a cholesterol-lowering drug would reduce the risks of heart attack and stroke by 20-40%, doctors from nine countries, including Bengaluru, reported Saturday.
The polypill can be taken alone or with aspirin with various benefits. If taken alone, it can reduce the chances of heart attack, stroke, or angioplasty by about 20%, but with aspirin, these chances are reduced by 40%.
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The study involved more than 5,714 patients at 89 centers in nine countries, including 39 centers in India over a period of eight years. The Indian phase of the trial was coordinated by the St John Research Institute and Medical College in Bengaluru.
“A polypill is not only effective, it is likely to be cost-effective as well, as it relies on the use of commonly used generic drugs,” said Prem Pais, study co-principal investigator and professor at St. John’s Medical College and Research. Institute.
Pais said the polypill is expected to “improve adherence” as it combines “several effective medications in a single pill and is taken once a day.”
The multi-drug pill combines simvastatin to lower cholesterol with atenolol; hydrochlorothiazide and ramipril. It can be combined with a daily dose of aspirin.
“This result is very encouraging,” said Balram Bhargava, director general of the Indian Council of Medical Research and former professor of cardiology at the Indian Institute of Medical Sciences in Delhi.
“This is another example of India’s contribution to global science. The polypill strategy is worth considering for widespread use. The costs can be further reduced for our people when they enter our national programs.”
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As the most common serious disease globally, cardiovascular disease causes 18 million deaths each year, with more than 80% of them in low- and middle-income countries. In India, almost 30% of all deaths and 15% of morbidities are caused by cardiovascular diseases. The numbers have doubled since 1990.
“We could save millions of people from serious heart disease or stroke each year with effective use of the polypill and aspirin,” said Salim Yusuf, co-principal investigator of the study and professor of medicine at McMaster University in Canada.
Published in the New England Journal of Medicine, the study in which participants took the drug for an average of 4.5 years showed that the benefits were greatest for those who took the drug without interruption.
“Studies of this nature are very difficult to carry out, since they involve many centers and the participants must be followed at least twice a year. In India, we recruited 49% of the total sample size. This was possible for us as we had built the collaboration over two decades, ”said Denis Xavier, a St. John’s professor and head of the clinical research division.
