Cheap ‘polypill’ lowers risk of heart trouble

A daily pill combining four cholesterol and blood pressure medicines taken with lowdose aspirin cut the risk of heart attacks, strokes and heart-related deaths by nearly a third in a large international study, which is expected to lead to wider use of the ‘‘polypill’’ approach.

For more than a decade, doctors have been testing whether the cheap, all-in-one combo pills could make it easier to prevent heart disease, the top killer worldwide.

‘‘It’s for all sensible countries,’’ said Dr Salim Yusuf of McMaster University in Hamilton, Ontario, who helped to lead the study and presented the results at an

American Heart Association conference. They also were published by the New England Journal of Medicine.

At least half a dozen companies sell polypills, but they are not widely used or marketed. Doctors have been reluctant to prescribe them, partly because no big, international studies have shown whether they can lower heart attacks and deaths, and not just risk factors such as high blood pressure.

The new study was very important and ‘‘the best data we have so far’’ on polypills, said Dr Eugene Yang, a University of Washington heart specialist who leads a heart disease prevention panel for the American College of Cardiology.

The new study tested Polycap, a pill from India-based Cadila Pharmaceuticals that sells in India for about NZ48 cents.

Researchers enrolled more than 5700 people, mainly in India and the Philippines as well as Colombia, Canada, Malaysia, Indonesia, Bangladesh, Tanzania and Tunisia. The men had to be at least 50 years old, and the women at least 55. All were at moderate risk of heart problems because of high blood pressure, diabetes or other conditions.

The polypill plus aspirin showed clear value, reducing heart-related problems and deaths by 31 per cent. The side effects were minimal.

‘‘We now have direct evidence’’ from several studies with clearly consistent results and no safety concerns about the value of polypills, said another expert with no role in the study, Anushka Patel, a cardiologist at Royal Prince Alfred Hospital in Sydney.

‘‘The public health impact enormous,’’ she said.

The study was partly funded by the Wellcome Trust, a British charity that supports research. . . . could be