Morning – A multi-pill would reduce the risk of cardiovascular events


A single daily pill combining high blood pressure, cholesterol and aspirin medications would reduce the risk of cardiovascular events (heart attack, stroke …) in five years in middle-aged people by a third, suggests a new study published last Friday. The idea of ​​such a pill nicknamed "polypill" and sometimes "superpilule", whose composition may vary, dates back about twenty years. But this new study, published by the medical journal "The Lancet", is the first large-scale study to evaluate its effectiveness in the population over such a period. This comparative trial, with random draw of those receiving polypill plus advice on healthy living (smoking cessation, physical activity …) or only advice, concerned a rural Turkmen population of Iran.
90% of the approximately 7,000 participants, aged 50 to 75, had no history of cardiovascular disease (CVD). Nearly half were women. Compared to lifestyle counseling alone, taking the combined pill reduced the risk of major cardiovascular events by 34% overall and by about 40% in people with no history of CVD over five years (4, 5% vs. 7.5%), and about 20% in patients already suffering from cardiovascular disease. In particular, the effects of treatment were similar for men and women and for the more or less young. After adjustment for people taking other cardiovascular drugs, the overall protective effect of polypill falls to 22% (34%), but remained statistically significant, "The Lancet". Overall, participants demonstrated a high level of treatment adherence: approximately 63% of them took the pill as recommended (at least 70% of the time).
The pill tested contained low doses of two antihypertensive drugs (a diuretic, hydrochlorothiazide 12.5 mg and enalapril 5 mg) and a moderate dose (20 mg) of an anti-cholesterol Atorvastatin, and 81 mg of aspirin, indicate Gholamreza Roshandel of the University of Medical Sciences of the Golestan Province of Iran and his colleagues. "More than three-quarters of the 18 million people who die of cardiovascular disease each year live in low- and middle-income countries," said Dr. Nizal Sarrafzadegan of the Isfahan University of Medical Sciences, co-author.
The strategy of a multi-pill, low price, "if adopted on a large scale, could play a key role in achieving the ambitious goal of the United Nations: reduce premature mortality from cardiovascular diseases of at least a third by 2030, "he says. The study does not allow to generalize to other populations. However, a pill containing a cocktail of drugs makes it easier to respect treatment. "Future studies should compare polypill to drugs taken separately, with long-term results," and also evaluate its effects on "the general population of different countries," says Dr. Amitava Banerjee (University College London), who is not involved in the study.

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