Source: Thailand Medical News Aug 25, 2019 5 years, 3 months, 4 weeks, 1 day, 12 hours, 36 minutes ago
A variety of studies conducted by the McMaster University in Canada, Tehran University of Medical Sciences and also University of Birmingham , all indicate that using a combination of our cheap generic drugs can reduce cardiovascular risk by about 80%. The cheap daily pill regimen that contained two blood pressure drugs, a cholesterol medicine and aspirin cut the risk of heart attacks, strokes and heart failure in a large study, suggesting it could be a good way to help prevent heart problems especially in poor countries.
The study involved the daily usage a four-component polypill including aspirin, atorvastatin, hydrochlorothiazide, and either enalapril or valsartan for primary and secondary prevention of cardiovascular disease.
The exact protocols involved hydrochlorothiazide 12·5 mg, aspirin 81 mg, atorvastatin 20 mg, and enalapril 5 mg and for those who had slight cough symptoms, an alternative protocol was used consisting of valsartan 40 mg instead of enalapril.
A previous study testing one in India found it lowered cholesterol and blood pressure. The new study is much larger and gives stronger evidence because it tracked heart attacks, strokes and other problems, not just risk factors.
Another study by Tehran University of Medical Sciences involved about 6,800 participants, ages 50-75, some with previous heart problems and others without them. All got advice on healthy lifestyles and half also were given polypills. After five years, 6% of those in the pill group had suffered a heart attack, stroke or heart failure versus 9% of the others. That worked out to a 34% lower risk with the polypill, and a 22% lower risk after researchers took into account other heart drugs that participants were taking.
Participants who took the polypill most faithfully, at least 80% of the time, had even bigger reductions in heart risks.
The benefit mostly seemed to come from lowering cholesterol; blood pressure did not significantly change. Side effects were similar in both groups. Some who developed a cough while on the polypill were switched to another version that substituted one of the four drugs. All of the drugs are available as cheap generic medicines.
Results of the study were published in the British journal
Lancet.
Dr. Salim Yusuf of McMaster University in Canada who leads another polypill study expected to finish next summer, commented in an interview with Thailand Medical News "This is an important step in the right direction. This could be used in every sensible country where we want to save lives."
One study leader, Dr. Tom Marshall of Britain's University of Birmingham, said the results show the polypill is a "viable strategy" to prevent heart disease in developing countries. It is much simpler to give people one medication that manages a couple of risk factors at the same time. The benefits however would be minimal for people who already have access to good health care. But where such care is not available or affordable by the masses, it would be a great significant advantage.
More studies are underway to see if the new polypill protocol is totally safe to become part of a nationwide public health policy in various countries and populations as it would be of great benefit
as cardiovascular diseases is the current cause of death globally at the moment
Reference : Gholamreza Roshandel et al. Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial, The Lancet(2019). DOI: 10.1016/S0140-6736(19)31791-X
