Major studies support cheap daily combo pills to reduce cholesterol and stroke risk

For over a decade, doctors have tested whether cheap all-in-one combo pills can help prevent heart disease, the world’s top killer. Friday’s results show its value as well as the poor countries.

“It’s for every wise country,” said Dr. Salim Yusuf of McMaster University in Hamilton, Ontario. “If developed countries don’t want profit, it’s their privilege.”

He helped lead the study and produced results at a conference of the American Heart Association. They were also published by The New England Journal of Medicine.

At least half a dozen companies sell polypills outside the United States, including some in Europe, but they are not widely used or sold. Physicians are reluctant, not only because of risk factors such as high blood pressure, but also because there is no large international study showing that they can reduce heart attacks and mortality.

“I think this depends on our results,” Yusuf said.

An independent expert agreed.

The study is very important and is “the best data ever” on polypills, said Dr. Eugene Yang, a cardiologist at the University of Washington, who heads the Heart Disease Prevention Panel of the American Heart Association.

In the United States, he said, “I could definitely see” using polypills where health inequalities are wide and access to care issues. 1 Small study Proposed profits in Alabama last year.

In a new study, India-based Cadila Pharmaceuticals Ltd, which includes three blood pressure drugs (atenolol, ramipril, “water pill” hydrochlorothiazide) and cholesterol-lowering statins. I tested Polycap, a pill of. In India, one tablet costs about 33 cents.

In addition to India and the Philippines, the researchers have enrolled more than 5,700 people in Colombia, Canada, Malaysia, Indonesia, Bangladesh, Tanzania and Tunisia. Men had to be over 50 and women had to be over 55. All had a moderate risk of heart problems due to high blood pressure, diabetes, or other conditions.

They were divided into groups and were given low doses of aspirin (75 milligrams), polypills only, polypills and aspirin, or placebopills. One group has been assigned to take vitamin D, but their results are not yet available. Neither the participants nor the doctors knew who was taking what until the end of the study.

The study was conducted for five years and was expected to involve 7,000 people, but drug delivery issues and the coronavirus pandemic forced researchers to shorten it. After a little over 4 years on average, aspirin alone showed no significant difference, and polypill alone tended to have a moderate effect.

However, the combination of polypill and aspirin showed clear value, reducing heart-related problems and mortality by 31%. About 4% of people in this group died or suffered from one of the heart problems being tracked, compared to about 6% of people taking placebopill.

Side effects were minimal. According to Yusuf, about 1.5% of polypill users had dizziness or low blood pressure, but if that happens, they can switch to lower doses.

Anushkapatel, a cardiologist at the Royal Prince Alfred Hospital in Sydney, Australia, and another expert, Anushkapatel, who was not involved in the study, gave clear and consistent results and the safety of polypill value. “There is direct evidence” from some studies that are not concerned about.

“The impact on public health … can be enormous,” she said.

The study was funded by Wellcome Trust, a British charity that supports the study. Cadila Pharmaceuticals; and other public and private research institutes.

Polypill companies need to seek regulatory approval to sell pills in different countries, and generic drug makers may work with large insurers to provide treatment, Yusuf said. It was. He hopes that guideline committees and groups such as Wellcome Trust, the World Health Organization, and the World Health Organization will advocate this approach. Many have already promoted this concept in medical journals.