Trial Begins of Another Polypill for Stroke and Heart Attack Prevention

Imagine a single pill that can cut heart attack risk by 88% and stroke risk by 80%. That was the theoretical benefit of a cheap five-ingredient generic combination pill proposed in a 2003 article by British researchers Wald and Law in the British Medical Journal. Since then, several studies have begun to study such a combination pill:

TIPS, a double-blind study in India, enrolled 2053 patients aged 45 to 80 years without cardiovascular disease but with one risk factor. Some participants received single agents while 412 received Polycap, a combination of hydrochlorothiazide 12.5 mg, atenolol 50 mg, ramipril 5 mg, simvastatin 20 mg and aspirin 100 mg.

Another study, Use of a Multidrug Pill in Reducing Cardiovascular Events (UMPIRE), is part of collaborative effort called Single Pill to Avert Cardiovascular Events (SPACE) being run by the George Institute in Sydney, Australia. Other trials in the SPACE collaboration include the Kanyini-Guidelines Adherence with the Polypill (GAP) study, which is currently under way in Australia, and the Improving Adherence Using Combination Therapy (IMPACT) trial ongoing in New Zealand.

The pill in the UMPIRE trial is called the “red heart pill” and comes in two different formulations. Participants who have previously had an MI will take a tablet containing aspirin, 75 mg; simvastatin, 40 mg; atenolol, 50 mg; lisinopril, 10 mg. The pill for stroke survivors will include the same amounts of aspirin, simvastatin, and lisinopril, but the atenolol is replaced by 12.5 mg of hydrochlorothiazide.

The newest study, aimed at healthy Brits over 50, was just announced in The Guardian. This time, aspirin has been eliminated from the pill formulation in order to minimize the risk for side effects.

Someone has likened the polypill to oral contraceptives. Maybe it is the ultimate vitamin? Or is it perhaps a way of medicalizing middle age for average risk people?

Trial begins of polypill that could prevent heart attacks and strokes | Society | The Guardian.