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Is a single pill the answer to preventing stroke and heart disease?

In a research study that is being hailed as a breakthrough in the prevention of stroke and heart disease, a five-in-one combination “polypill” has been shown to be just as effective as five individual tablets at reducing risk factors like blood pressure.

The polypill (or “Polycap”) contains three blood pressure medicines (a beta-blocker, an ACE inhibitor, and a diuretic), as well as a statin and aspirin. In a trial which took place in over 50 centres in India, 412 healthy volunteers took the Polycap and over 2000 volunteers took individual blood pressure and cholesterol-lowering tablets, over a 12-week period. Each volunteer had one “risk factor” for heart disease and stroke, such as high blood pressure.

The results of the trial showed that the Polycap reduced blood pressure and heart rate as effectively as the individual tablets. Cholesterol was reduced, but not quite as much as with the statin on its own.

The study’s authors claim that if people at a low to moderate risk of heart disease and stroke were given the Polycap to take regularly, it could lower the number of strokes and heart attacks by up to half. Some commentators have argued that if people at high risk took the tablet, the numbers could be lowered by as much as 75%.

The results of the trial are very encouraging, and some commentators might suggest there is a strong case for giving the pill to everyone with a raised risk, or even anyone over a certain age. The prospect of taking a single pill every day would be less worrying than having to take all five tablets separately. However, others warn that using a polypill runs the risk of turning otherwise healthy people into “patients”.

Commenting on the research, Mike Rich, Executive Director of UK charity the Blood Pressure Association, said: "This study further stimulates the debate over whether a 'magic bullet' is the answer to the prevention of heart disease and strokes. Eating healthily and taking regular exercise are proven ways to lower high blood pressure - and have many other health benefits too - and there is a danger that these lifestyle factors could be overlooked in favour of 'popping a pill'. We look forward with interest to see if the researchers' theory of this polypill halving strokes and heart attacks in middle-aged people can be realised in practice."

Source: American College of Cardiology Conference 2009 

Topics: Research, Medicines, High blood pressure

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