Polypill with aspirin can reduce risk of heart disease

By Alex Brown | Contributor

A polypill is a single, daily pill combining multiple medications to control multiple health risk factors, such as high blood pressure, high cholesterol, stroke, type 2 diabetes or heart disease. An exciting breakthrough in managing cardiovascular events in those at risk of heart disease has been developed by utilizing the polypill. It was found that the combination of blood pressure and cholesterol medications i.e, a polypill along with a daily dose of aspirin reduced cardiovascular disease by 31%, and that the polypill without the addition of aspirin was still able to produce a reduction by 21%.

The research, presented at the American Heart AssociationÔÇÖs Scientific Sessions and published in The New England Journal of Medicine, aimed to assess the polypillÔÇÖs effects when given along with aspirin. They also evaluated the effects of aspirin alone.

The International Polycap Study (TIPS)-3 was a large, randomized, placebo-controlled trial that took place in 9 different countries. The study involved 5,700 people, who were all considered to be at risk of developing heart disease. 53% of participants were female, and the mean age was 64 years.

Participants were randomly assigned to different cohorts each receiving different pills and dosages. The cohort groups were: 75mg daily of aspirin; polypill for cholesterol and blood pressure medication; polypill and 75 mg of aspirin; and vitamin D 5000 IU daily. Each group also had a corresponding control who received the matching placebo. 

Over a 5 year follow up period, participants were monitored for the first occurrence of a major cardiovascular event including incidences of non-fatal heart attack, non-fatal stroke, heart failure, resuscitated cardiac arrest or cardiovascular death.

Analysis of the above cohorts found that: polypill alone reduced cardiovascular disease by 21%, aspirin alone resulted in a 14% reduction in major cardiovascular events and the combination of polypill and aspirin reduced cardiovascular disease by 31%.

Salim Yusaf M.D., B.S., D. Phil Co-Author of the study and Professor of Medicine at McMaster University School of Medicine in Toronto, Canada said:

“Our study results provide important data regarding the role of the polypill in preventing development of heart disease. [The results show] aspirin should be prescribed with a polypill in a primary prevention for patients at intermediate risk of heart disease.”

Yusaf is also hopeful for the future of the polypill, adding:

“use of a polypill plus aspirin can avert 3-5 million cardiovascular deaths globally. Future polypills, with newer statins, may reduce LDL (low density lipo-protein) cholesterol and blood pressure to greater extent and could reduce cardiovascular disease risk greater than 50%.”

Co-author Prem Pais, M.B.B.S., M.D., Professor in the Division of Clinical Research and Training at St. John’s Research Institute in Bangalore, India, commented:

“We were also interested in evaluating if combining blood pressure and cholesterol reduction medications in a single pill would be effective for this population. This is a cost-effective strategy that could help meet global targets of reducing cardiovascular disease by 30% by 2030.”

These promising results suggest polypills may have a role either alone as a combination therapy with aspirin in the treatment of heart disease.