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Heart attacks halved with daily 'polypil', strokes reduced: Study

PARIS: Cheap, one-day pills that combine aspirin with medications that lower blood pressure and cholesterol lower cardiovascular disease by a third and heart attacks by more than half, researchers said Friday (August 23rd).

In clinical trials, the so-called "polypil" was particularly effective in people without a history of cardiovascular disease, reducing the number of severe events by 40 percent, researchers in the Lancet medical journal said.

For those with a history of heart problems and strokes, the drug vans were only half as effective as the control group, who received healthy living advice but no drugs.

For participants taking regimen pills – at least 70% of the time, the incidence of heart attack decreased by 57%.

The concept of polypil was first proposed more than 20 years ago as a simplified, economical approach to treating cardiovascular disease, which often requires several drugs.

Currently, patients are prescribed one or more blood pressure lowering medications along with statin, which controls lipids such as fatty acids. Aspirin, an analgesic, has blood-thinning properties.

"The more pills people need to take, the less they will adjust in the long run," said Kausik Ray, a professor of public health and Imperial College in London who is not involved in the study.

"For chronic illnesses, this is a challenge because you ask people to take more medication every day for 30 or 40 years."

According to previous research, about a third of patients stop treating them even 90 days after a heart attack.

But despite its obvious potential, the polyp has yet to be tested on many people over a long period of time.

Scientists led by Reza Malekzadeh of Tehran University of Medical Sciences have recruited nearly 7,000 men and women, aged 50 to 75, living in rural Golestan, a province in Iran.

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About one in 10 have previously had a heart attack, stroke or other cardiovascular episodes.

The participants were divided into two groups of approximately the same size. Only one was given "life advice", while the other also received a daily polypile from 2011 to 2013.

Doctors monitor drug compliance and then increase the number of strokes and heart attacks in each group over the next five years.

In general, adherence was significantly greater with all-in-one tablets.

"Drugs don't work unless taken," said Amitawa Banerjee, a consultant cardiologist at University College London.

Compared to the lifestyle group, the polypil group had 34% less side effects. The results were similar in men and women.

Blood pressure was not much different, but cholesterol levels in the "bad" (LDL) were lower in the drug group.

"We now know that a fixed-dose polypil can achieve clinical benefits in practice," Malekzade said in a statement.

"But polyposis is not an alternative to a healthy lifestyle and should be combined with physical activity, a healthy diet and smoking cessation."

Other researchers not included in the study said the findings could be a game changer, especially in developing countries.

"Given the availability of polypil, there is significant potential to improve cardiovascular health and prevent the leading cause of death worldwide," said co-author Nizal Sarafzadegan, a researcher at Isfahan University of Medical Sciences.

"Over three quarters of the 18 million people who die of cardiovascular disease each year live in low- and middle-income countries."

Some experts – including the authors themselves – have said that further investigations are needed to see if the polypil will prove effective in other populations.

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