Heart Health

31 March 2009

Superpill may cut heart disease

Healthy people could cut their risk of heart disease in half with a new "super pill" that combines low doses of aspirin and drugs that lower blood pressure and cholesterol.

Healthy people could cut their risk of heart disease in half with a new "super pill" that combines low doses of aspirin and drugs that lower blood pressure and cholesterol, a study said.

"We believe that the polypill probably has the potential to reduce heart disease by 60% and stroke by 50%," lead investigator Salim Yusuf said at the American College of Cardiology's annual meeting, where the study was presented.

"The thought that people might be able to take a single pill to reduce multiple cardiovascular risk factors has generated a lot of excitement. It could revolutionise heart disease prevention as we know it," Yusuf said.

5 active ingredients in 1 pill
In the three-month study cardiologists compared the impact on blood pressure, cholesterol and heart rate of the combination "polypill" and the medications that make it up, taken individually or together.

The study involved 2 053 patients, recruited from heart centres around India between March 2007 and August 2008. The polypill contains low doses of three medications against high blood pressure; simvastatin, which lowers LDL - or bad cholesterol - and aspirin, a known blood-thinner.

"Before this study, there were no data about whether it was even possible to put five active ingredients into a single pill," the study said. "We found that it works," the researchers said.

Works as well as regular meds
Participants in the study were divided into groups and given either the polypill or aspirin, the cholesterol-lowering medication, or one of the three blood pressure medications on their own; different combinations of blood pressure medications, or all three blood pressure treatments with or without aspirin.

The researchers found that blood pressure in participants in the polypill group was lowered as much as in the group taking the three blood pressure medications together, with or without aspirin. Those blood pressure reductions "could theoretically lead to about a 24% risk reduction in congestive heart disease and 33% risk reduction in strokes in those with average blood pressure levels," the study said.

The polypill reduced LDL cholesterol significantly more than in all other groups except the one in which simvastatin was taken alone. The simvastatin group's LDL levels fell only slightly more than the polypill group, the study found.

Heart rates in the polypill group and the group taking one of the blood-pressure medications, atenolol, fell by seven beats a minute - significantly more than in the other study groups.

Pros and cons
Side-effects in patients taking the polypill were the same as when taking one or two medications, the study found. "The side effects of one drug may be counteracted by beneficial effects of another. So the rate of stopping medications was the same," it said.

The study was "a critical first step to inform the design of larger, more definitive studies, as well as further development of appropriate combinations of blood-pressure lowering drugs with statins and aspirin," said Yusuf.

Step closer to beating heart disease
Dr Christopher Cannon, a cardiologist from Harvard University, said the polypill took the medical world a step closer to beating heart disease, a leading cause of death worldwide. Some 80% of heart disease cases are thought to occur in developing countries.

"The concept is simple. Several different drugs are available (generically and thus inexpensively) to treat many of the cardiac risk factors. So, combining them in one pill could reduce heart disease by 80%," Cannon said in a comment piece in The Lancet, in which the results of the study were published.

"This approach has obvious appeal and vast implications for global health, because heart disease is the leading cause of death worldwide," he wrote. – (Jean-Louis Santini/Sapa)

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