Treatment

CVD Risk Is Lowered by Polypill, Aspirin

A new polypill containing blood-pressure- and cholesterol-lowering medication, with or without the addition of aspirin, reduces cardiovascular disease (CVD) events in at-risk patients, according to the results of a recent clinical trial presented at the American Heart Association’s Scientific Sessions 2020.1  

This result comes as part of the International Polycap Study (TIPS)-3, a randomized, placebo-controlled trial to test the effectiveness of this fixed-dose combination therapy. The study investigators also examined the impact of aspirin alone and in combination with the polypill.

To be included in the study, patients had to be at intermediate risk for myocardial infarction, stroke, and cardiovascular death. The trial included 5700 individuals from 9 countries. The participants’ average age was 64 years, and 47% of the individuals included were men.

The participants were randomly assigned to receive one of the following interventions daily:

  • Aspirin, 75 mg
  • A polypill containing both blood pressure medication and a statin
  • A combination of the polypill and aspirin, 75 mg
  • Vitamin D, 5000 IU
  • Placebo

 

Medications included in the polypill were atenolol, 100mg; ramipril, 10mg; hydrochlorothiazide, 25mg; and simvastatin, 40mg.

The results indicated that the polypill alone reduced CVD by 21%, while aspirin alone reduced cardiovascular death, myocardial infarction, and stroke by 14%. When used together, the polypill and aspirin reduced CVD by 31%.

The trial included a follow-up period of 5 years. During which, participants were monitored for nonfatal myocardial infarctions, nonfatal strokes, heart failure, cardiac arrest, and cardiovascular death.

“Use of a polypill plus aspirin can avert 3-5 million cardiovascular deaths globally,” said Salim Yusuf, MD, BS, DPhil, a co-author of the study and professor of medicine at McMaster University School of Medicine in Toronto, Canada.2  “Future polypills, with newer statins, may reduce LDL cholesterol and blood pressure to a greater extent and could reduce cardiovascular disease risk greater than 50%.”

 

—Leigh Precopio

 

References:

  1. Joseph P, Dans AL, Bosch J, et al. Aspirin alone and in combination with a polypill in cardiovascular disease primary prevention: results from the International Polycap Study (TIPS)-3. Paper presented at: AHA Scientific Sessions 2020; November 13-17, 2020; Virtual. https://www.abstractsonline.com/pp8/?#!/9144/presentation/40152
  2. New study confirms combo pill along and with aspirin lowers heart disease risk. News release. American Heart Association. November 13, 2020. Accessed November 19, 2020. https://newsroom.heart.org/news/new-study-confirms-combo-pill-alone-and-with-aspirin-lowers-heart-disease-risk?preview=ff77