International trial finds polypill halves predicted heart disease and stroke risk

The world's first international polypill trial has shown that a four-in-one combination pill can halve the predicted risk of heart disease and stroke. The results were published in the open access journal 'PLoS One'.

The once-a-day polypill contains aspirin and agents to lower blood pressure and cholesterol. These drugs are currently prescribed separately to millions of patients and are known individually to cut the risk of disease, but many experts believe that combining them into a single pill will encourage people to take the medications more reliably.

The trial tested the effectiveness and tolerability of the polypill in 378 people with raised risk of cardiovascular disease, who did not necessarily have high blood pressure or cholesterol, against a placebo. The participants came from the UK, Australia, Brazil, India, New Zealand, The Netherlands and the USA, with core funding for the central coordination of the trial provided by the Wellcome Trust.

"The results show a halving in heart disease and stroke can be expected for people taking this polypill long term," said Professor Anthony Rodgers of The George Institute for Global Health, who led the international consortium.

"We know from other trials that long term there would also be a 25-50 per cent lower death rate from colon cancer, plus reductions in other major cancers, heart failure and renal failure," Professor Rodgers said. "These benefits would take several years to 'kick in', but of course one of the hopes with a polypill is it helps people take medicines long term."

National trials of similar combination 'polypill' treatments have previously been conducted in India, Iran and Sri Lanka, but this is the first trial to combine data from patients at international centres and the first to look reliably at the incidence of side-effects against a placebo.