ACC: Polypill May Reduce Cardiovascular Risk

Combo treatment with anti-hypertensive drugs, a statin and aspirin suggests favorable results

01 april 2009-- A polypill -- a combination of three blood-pressure-lowering drugs at low doses, with a statin, aspirin and folic acid -- could significantly reduce cardiovascular events in otherwise healthy patients, according to an article published online March 30 in The Lancet to coincide with the American College of Cardiology's 58th Annual Scientific Session held March 29 to 31 in Orlando, Fla.

Salim Yusuf, M.D., of McMaster University in Hamilton, Ontario, Canada, and colleagues randomly assigned 2,053 Indian patients aged 45 to 80 who were free of heart disease but had one risk factor to receive either a polypill containing low doses of thiazide, atenolol, ramipril, simvastatin and aspirin or aspirin alone, simvastatin alone, hydrochlorthiazide alone, three combinations of the two blood-pressure-lowering drugs, three blood-pressure-lowering drugs alone, or three blood-pressure-lowering drugs plus aspirin.

The researchers found that the polypill reduced systolic blood pressure by 7.4 mm Hg and diastolic blood pressure by 5.6 mm Hg, which was similar when three blood-pressure-lowering drugs were used, with or without aspirin, compared with groups not receiving blood-pressure-lowering drugs. They also found that the polypill reduced low-density lipoprotein (LDL) cholesterol by 0.70 mmol/L, which was less than that with simvastatin alone.

"Our findings emphasize that the effects of the polypill cannot be assumed to equal the combined effects of its individual components," the authors write. "Every preparation of a combination pill needs to be tested to assess its pharmacokinetic and pharmacodynamic effects, before it is used in larger studies examining clinical outcomes. The substantial preservation of the lowering of blood pressure, heart rate, LDL cholesterol, and 11-dehydrothromboxane B2 with the Polycap suggests that it has the potential to greatly reduce cardiovascular disease."

The study was supported by Cadila Pharmaceuticals, Ahmedabad, India; one of the authors disclosed a financial relationship with Cadila.

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