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5-in-1 'Polypill' Reduces Heart Disease Risk Factors

A new study suggests that combining several medicines in one pill may be an effective way to reduce heart attacks and strokes.

The so-called "polypill" or "polycap" combines aspirin, a statin drug to lower cholesterol, and three blood pressure medicines.

All these medicines are known to lower the risk of heart attacks and strokes, but Dr. Koon Teo of McMaster University in Canada says it's difficult to get seemingly healthy people to take a bunch of drugs every day.

"Especially if they feel good, they say, 'Why do I have to take all these pills? You mean for the rest of my life?'

"And of course, if they don't take the pills, they don't get the benefit. So we thought, well, if we can manage to put five or four medications into a pill, then it simplifies the process. They will only take one pill a day. And that's it."

Teo is one of the researchers behind the study, which was presented on March 30 at a meeting of the American College of Cardiology and published online by the British medical journal, The Lancet.

The study, which involved 2,000 middle-aged men and women in India, found that the polypill was successful in lowering blood pressure and cholesterol without many side effects. In fact, the side effects from the polypill actually seemed lower than from taking the drugs individually. But Teo says they'll need to do more extensive tests to see if the polypill actually reduces cardiovascular illness and death, not just the risk factors that can lead to heart disease

"We need to prove it in a bigger population and for longer, so that we can actually see the effects of this polypill in reducing heart attacks and strokes," he said.

The study was funded by the Indian company which is developing the polypill, Cadila Pharmaceuticals.

If successful, the polypill would likely be available in just a few standard doses. Patients with more complex needs would still probably have to take individual drugs. But the hope is that an inexpensive, standard polypill could help many people reduce their risk of heart attack and stroke.

Christopher Cannon is a cardiologist at Brigham and Women's Hospital in Boston and is the author of a commentary that accompanied the research paper. He stresses that people taking cholesterol or blood pressure medicine don't have license to eat unhealthy food or avoid exercise.

"That actually is a very big worry. We're continuing to say that we really need both - a healthy lifestyle and medication when it fits in to help treat the risk factors."

Heart disease is the world's No. 1 cause of death, and Dr. Cannon says it's no longer a disease mainly of Western industrial countries.

"Well, unfortunately, the problem is now growing around the world," said Cannon. "And this is tracking with the so-called Western diet that is not very healthy, and the consequent increase in obesity or being overweight, and these are the risk factors that track with that. And so people start to pick up more and more risk factors for heart disease."

In his commentary, Cannon writes that the simplicity and presumed low cost of the polypill would be particularly well suited to areas with less access to medical care. But both he and Dr. Teo say it also might make it easy for patients in richer countries to protect themselves without having to take a handful of pills every day.