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Major 'polypill' study shows significant CVD care improvement

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Patients at high risk of heart attack or stroke display a significant improvement in risk factor control when they are given a “polypill”, rather than the usual care.

A polypill is a combination of standard use cholesterol lowering and blood pressure medication along with aspirin.

The Single Pill to Avert Cardiovascular Events (SPACE) project analysed data from 3,140 patients with established CVD or at high risk of CVD in Europe, India and Australasia.

“These results emphasise the importance of the polypill as a foundation for a global strategy on cardiovascular disease prevention”

Salim Yusuf

The researchers found a 43% increase in adherence to the medication after 12 months, as well as improvements to systolic blood pressure levels, when patients were given a polypill instead of separate drugs.

The most significant benefit was experienced by those patients who did not receive the full range of treatment prior to the study, which is representative of most CVD patients globally.

“These results are an important step forward in the polypill journey and management of cardiovascular disease”, said lead author Ruth Webster, from the George Institute for Global Health, Sydney.

The George Institute

Ruth Webster

She added: “Most patients globally either don’t start or don’t continue taking all the medications they need, which can lead to untimely death or further CVD events.

“An important finding from our analyses is that the greatest benefits from a polypill were for currently untreated individuals.

“Although the idea of a polypill has always been appealing, we now have the most comprehensive real-world analysis to date of this treatment strategy in high risk CVD patients,” she said. “Given the potential affordability, even in low income countries, there is considerable potential to improve global health.”

Professor Salim Yusuf, president-elect of the World Heart Federation, said: “These results emphasise the importance of the polypill as a foundation for a global strategy on cardiovascular disease prevention.

“It will improve patient access to essential medications at an affordable cost and wide use of the polypill can avoid several millions of premature CVD events.

World Heart Federation

Salim Yusuf

He added: “The polypill is however not a replacement for a healthy lifestyle and should be combined with tobacco avoidance, a healthy diet and enhanced physical activity.”

SPACE combined results from three clinical studies which took place from 2009 - 2013: UMPIRE (Europe and India), Kanyini-GAP (Australia) and IMPACT (New Zealand).

The data from the study was presented at the World Heart Foundation’s World Congress of Cardiology 2014.

Further analysis of the data is under way to investigate the effect of the polypill on major patient groups and the results of this are expected over the coming year.

The polypill concept for cardiovascular disease is usually credited to Professor Sir Nicholas Wald and Professor Malcolm Law, both from the Wolfson Institute of Preventive Medicine in London.

They first proposed using a combination of well-known and inexpensive medications in one pill for protection against cardiovascular disease in the BMJ in 2003.


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