A polypill can prevent millions of premature deaths, heart attacks, and strokes every year

Heart attacks and strokes were cut by 35 to 50 percent by using a polypill.
Deena Theresa
Low-cost blood pressure lowering drugs, statins and aspirin widely in the form of a single pill, also known as the polypill.
Low-cost blood pressure lowering drugs, statins and aspirin widely in the form of a single pill, also known as the polypill.

McMaster University 

A polypill could be the one-stop solution or savior to solving the world's heart problems and premature deaths, according to leading cardiologists.

But what's a polypill?

Doctors generally prescribe a polypill — a combination of medicine that includes three primary drugs; a statin that lowers cholesterol, an Angiotensin-converting enzyme (ACE) inhibitor to lower blood pressure, and a blood thinning agent like aspirin — to patients who have recovered from heart attacks. This amalgam of medicines can prevent further heart problems.

Earlier in August, Spanish researchers developed a polypill named "Trinomia," which combined several heart medications into a single pill. Researchers kept track of their cohort, which comprised people recovering from a heart attack, and found that treatment with a polypill "resulted in a significantly lower risk of major adverse cardiovascular events than usual care."

Now, in a commentary published Tuesday in The Lancet, Professor Fausto Pinto, president of the World Heart Federation, and Professor Salim Yusuf, Executive director of the Population Health Research Institute (PHRI) and Professor Emeritus of Medicine at McMaster University, state that widespread availability of polypills would largely reduce the risk of cardiovascular disease (CVD) and be affordable for most people globally.

A polypill to save millions of lives

In a press release, Pinto said: "Despite substantial scientific evidence of the high effectiveness, safety, and affordability of the polypill, few such combined products are available, and in the few countries where they are available, use is low."

Heart disease is the leading cause of death in the world. Around 54 million people suffer from CVD every year, and a third of them die from the disease. According to the statement released, 80 percent of them live in low-income and middle-income countries.

"The current strategy for primary and secondary prevention of CVD has only been modestly successful in most countries, including high-income countries. Even in these countries, fewer than half of patients with prior CVD, and fewer than 20 percent without prior CVD, receive effective preventive treatments," said Yusuf.

The polypill was first proposed in the early 2000s to reduce CVD substantially and at an affordable cost.

Adding polypills to the WHO's list can increase usability

Several of Yusuf's research has revealed that heart attacks and strokes were cut by 35 to 50 percent by using a polypill.

"The answer is now clear and resounding, with data from three independent, large, and long-term trials in primary prevention and one in secondary prevention showing its life-saving significance," he said.

So, how can the use of polypills be adopted? In the published paper, Pinto and Yusuf recommend encouraging large pharmaceutical companies to invest in developing and testing polypills. Manufacturing them with "generic" components and marketing them at lower prices would work well with both customers and the companies.

Currently, polypills are not included in the WHO's Essential Medicines List. Adding them to the list and in guidelines for primary and secondary prevention of CVD would be a big leap. "This would encourage governments and insurance companies, especially in low-income and middle-income countries, to include in their formularies, and clinicians to recommend its use," write the experts.

Lastly, combining the polypill with advice to improve lifestyles can help to a large extent. "It is time to use the polypill widely to save millions of lives each year," added Pinto.

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