A single 3-in-1 pill reduces death from cardiovascular diseases

A polypill developed by Spanish researchers reduces the risk of strokes and cardiovascular death by 33%. The drug named “Trinomia” combines several heart medications into a single pill — hence the name polypill. After following patients recovering from a heart attack, researchers found that treatment with a polypill “resulted in a significantly lower risk of major adverse cardiovascular events than usual care.”

What’s in the polypill?

Typically, after a patient recovers from a heart attack, doctors prescribe several medications to prevent additional heart problems in the future. These cardiovascular medications usually include three drugs; a blood thinning agent like aspirin, a cholesterol-lowering statin, and an ACE inhibitor to lower blood pressure. Researchers combined all three medications into a single pill and tested 50 variations to come up with the right recipe that would be the most beneficial.

To test the polypill, a team of researchers from the Spanish National Center for Cardiovascular Research (CNIC) recruited 2,499 participants from seven countries. Participants were recruited following a heart attack and randomized into either taking Trinomia or a standard therapy, which involved taking each of the medicines separately.

Over the next three years, researchers found that patients taking the polypills had a 33% lower cardiovascular mortality rate than those taking the three drugs separately. There were 71 deaths in the group that received standard treatment, compared to 48 in the polypill group.

The team also kept track of four major cardiovascular events; death from heart-related issues, another non-fatal heart attack, a non-fatal stroke, and a blocked artery requiring revascularization. Results revealed that patients taking the polypill had a 24 percent lower risk of all four events than the other group.

Why is a single pill better than three?

The problem with multiple pills is that patients often do not stick to their medication regimens. Studies have shown that less than 50 percent of patients continue to take all their medications as instructed.

“Although most patients initially adhere to treatment after an acute event such as an infarction, adherence drops off after the first few months,” said Dr. Fuster, lead researcher on the trial.

That’s where polypills come in. It’s based on the theory that patients adhere to their treatment more when they only have to take one pill rather than multiple ones. Simply because it’s easier to take one pill than juggling all of the pills separately. A single pill also reduces the likelihood that a person will forget a potentially life-saving drug.

“By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent cardiovascular disease and death on a global scale,” Dr. Fuster concludes.

Cardiovascular diseases are the leading cause of death globally. In 2019, 17.9 million people died from these diseases, accounting for 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.

The polypill may be less expensive to produce and distribute than a series of different pills. This could help make cardiovascular prevention therapy more accessible, especially to individuals in low-income and middle-income countries.