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Daily Four-Drug Combo Pill Halves Heart Disease Risk: Study
Date:5/26/2011

igrams of the blood pressure drug hydrochlorothiazide (a diuretic) and 20 milligrams of the cholesterol-lowering statin Zocor (simvastatin).

The new study included 378 people, typically between the ages of 50 and 70 and assessed to be at a moderately heightened risk for heart disease over the next five years. The participants, who were randomly assigned to receive the polypill or a placebo, came from the United Kingdom, Australia, Brazil, India, New Zealand, the Netherlands and the United States.

Over 12 weeks, people taking the polypill saw an average reduction in their systolic blood pressure (the top number in a reading) of 9.9 mmHg, and what Rodgers called a "significant" 0.8 mmol/L average reduction in their LDL "bad" cholesterol, compared with those receiving placebo. Improvements such as these added up to an estimated halving of cardiovascular risk, the team said.

However, about one in every six people taking the polypill experienced some sort of side effect, the team added. In fact, about one in every 20 users quit the drug because of this, a higher rate than had been seen in prior studies involving the polypill.

Overall, the benefits of the polypill, while significant, were not as large as others have suggested, Rodgers said, and side effects were not as limited as had been thought. Given that finding, Rodgers' group thinks the polypill should be given primarily to those at risk for heart disease or stroke.

Another expert agreed that the study offered up good news and bad.

"There were significant reductions in blood pressure and lipid [blood fat] levels," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles. "However, the polypill was less well-tolerated than expected."

Still, he said there's been longstanding interest in developing a single pill with fixed-dose combinations of heart-protective medications, especially for use by people in the developing world who ma
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