Canadian researchers say a single, daily pill combining five medicines could potentially cut by half the number of heart attacks and strokes in middle-aged people.
The pill — called Polycap — is a cocktail of three blood-pressure lowering drugs, Aspirin to reduce blood clotting and a cholesterol-lowering drug. In tests involving more than 2,000 people in India, each component of the pill did what it was supposed to do.
In addition, the Polycap was generally well tolerated. There was no evidence of increasing side effects with increasing number of active components in one pill.
The 12-week study wasn’t designed to see whether the “polypill” actually reduced heart attacks, stroke and death. Larger numbers of people would need to be treated with a longer followup.
“The worry, of course is, would they just take this and sit in front of a TV and not exercise and gain even more weight,” Cannon, a spokesman for the American College of Cardiology, said in an interview. “This has to be done in concert with all the things we’re supposed to be doing — eating better, exercising more and losing weight.”
The study involved 2,053 people, aged 45 to 80, without cardiovascular disease but with one risk factor for it, such as hypertension, obesity, high cholesterol, diabetes or smoking.
The research team wanted to know: Is it possible, physically, to put five different ingredients into one pill? Would it work the same way as taking the compounds separately? Would it be tolerated? Would there be unexpected interactions when the drugs are given in a single pill?
Overall, the Polycap lowered blood pressure, cholesterol and the clotting ability of the blood “in the same way as if I were taking the pills separately,” says Dr. Koon Teo, professor of medicine at McMaster and cardiologist at Hamilton Health Sciences. However, it lowered cholesterol slightly less than what would be achieved with taking the cholesterol reducer simvastatin alone.
There were no excess side effects, Teo says. “So it looks like it’s safe.”
”We were excited because it’s a new paradigm of treatment,” he said.
Getting patients to take multiple drugs, even after a heart attack, is difficult. Teo says the major appeal of the polypill is its simplicity. “People are more likely to take one pill, than five.”
As well, large numbers of people with risk factors, such as high blood pressure, are untreated, Cannon says.
“If all these patients knew they could simply take their polypill, they might be more receptive to it,” he writes in The Lancet.
But the findings suggest the pill could potentially reduce cardiovascular heart disease by 62 per cent, and stroke by 48 per cent, researchers from McMaster University in Hamilton and St. John’s Medical College in Bangalore, India write in the journal, The Lancet. The study is to be presented Tuesday at the American College of Cardiology meeting in Florida.
Heart disease is the leading cause of death worldwide.
The study is a “first and crucial step” toward realizing the dream of combining several different drugs into one pill to treat many cardiac risk factors, says Dr. Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston and an associate professor of medicine at Harvard Medical School.
”We’re not all the way there yet. We do need a larger study to show this does in fact work for the longer term. But it’s a big step toward having a simple pill that could provide this broad cardio-protection to tens of millions of people worldwide.”
The Polycap, which is manufactured by Cadila Pharmaceuticals in Ahmedabad, India, contains generic drugs. Cannon says each component would add up to about $17 U.S. a month.
In an accompanying commentary, Cannon worries the availability of a “single magic bullet” for the prevention of heart disease could lead people to think popping a pill would solve all their problems.
