- New research suggests a combination of generic drugs in a single “polypill” taken each day can reduce the risk of heart problems by as much as half.
- Because it’s cheap and easy to use, the treatment could be especially promising for low-income populations.
- But some medical professionals have said a one-size-fits-all approach still isn’t the best way to protect heart health.
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Taking a single medication to prevent a heart attack sounds too good to be true, but a new study shows such a pill can be effective. And yet, doctors are divided on whether it’s really the best solution for heart problems, the number one cause of death in the world.
For the study, published Aug. 23 in The Lancet, researchers funded by Tehran University of Medical Sciences looked at more than 6,000 participants, ages 40 to 75, who were assigned to either take the pill daily or to follow healthy lifestyle guidelines like keeping a healthy diet, exercising regularly, and not smoking.
The specific pill, a combination pill also known as “polypill,” contained four different drugs typically used to treat precursors of heart problems like high cholesterol and high blood pressure – aspirin, atorvastatin, hydrochlorothiazide, and enalapril or valsartan.
The researchers found that those who took the polypill consistently were up to 57% percent less likely to have a major cardiovascular event like a heart attack or stroke during the five years of the study.
The polypill was shown to be both effective and easy to use
Overall, patients who took the polypill were found have cut their risk of cardiovascular problems by one-third compared to the control group, with fewer incidents of heart attack, stroke, and heart failure.
This success was even more prominent among people who were diligent with the medication and took it at least 70% of the time. They cut their risk by more than half, 57%, compared to the control group.
Researchers also found the pill had a high adherence rate, a crucial factor for a drug to work in at-risk populations. More than 80% of participants in the study consistently took their medication.
This is a major advantage of the polypill compared with more complex regimens of multiple drugs. Medication only works when people take it as prescribed, and taking multiple capsules several times a day can increase the chances that a patient will forget or even skip a dose because of the inconvenience.
Interestingly, researchers found the polypill worked primarily by supporting healthy choleserol levels and had only a minor effect on blood pressure, although a blood pressure drug was part of the pill.
Not all health experts support a polypill for heart problems
Some doctors, however, have expressed skepticism about the pill.
“Just throwing a little bit of this and that at people isn’t doing justice to understanding what people need. Everyone as they age is going to have different needs,” Dr. Joshua Yamamoto, cardiologist and medical director at the Foxhall Foundation, told Insider.
He explained that the primary benefit of the polypill seems to be from just one component, the atorvastatin. Also known by the brand name Lipitor, it’s part of a class of drugs called statins that have long been known to help prevent cardiovascular problems.
“The magnitude of the benefit is likely entirely due to the atorvastatin,” Yamamoto said. “The notion that the polypill was better than Lipitor alone was not borne out by the data.”
In addition, the drugs included in the polypill can have side effects, he noted. Aspirin can cause excessive bleeding and atorvastatin can cause fatigue and muscle weakness (albeit in a small percentage of the population). “Everything has side effects,” he added.
Ultimately, Yamamoto said, a cheap, widely-available medication can be a good thing, but it’s not a replacement for other best-practices for heart health, including individualized treatment and lifestyle factors like healthy diet and exercise. It can also give people a false sense of security, discouraging them for other important preventative measures of heart health, such as regular blood pressure checkups.
“The right pill for the right person at the right time is really good,” he said. “But we want people to ask, to say, ‘I’m not an average, I’m not a statistic.’ If you stop asking those questions about what’s right for each person, you do everybody a disservice. Asking questions is free.”