Polypill significantly reduces chance of cardiovascular death in at-risk patients: Study

OVIEDO, Spain

A polypill developed by Spanish researchers reduces the risk of cardiovascular death in people who have had heart attacks by 32%, according to a study published on Friday in the New England Journal of Medicine.

The polypill combines three drugs — aspirin, a statin and an angiotensin-converting enzyme (ACE) inhibitor — that are commonly used to treat people at risk for or suffering from cardiovascular diseases.

After following nearly 2,500 patients recovering from a heart attack in a Phase 3, randomized trial for at least three years, researchers found that treatment with a polypill “resulted in a significantly lower risk of major adverse cardiovascular events than usual care.”

To be precise, 48 patients in the polypill group died from cardiovascular events compared to 71 patients in the traditional care group — a 32% reduction. Patients on the polypill also saw similar drops in negative events like non-fatal heart attacks and strokes.

The primary way the polypill works is by making it easier for patients to take their medications properly. Researchers found that 50% of patients who had a heart attack do not consistently take all their prescription drugs, but that adherence increases if they only have to take a single pill.

These were the results of the long-awaited SECURE trial, the first of its kind to study a polypill on post-heart attack patients.

“By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent disease and cardiovascular death on a global scale,” Spanish researcher Valentin Fuster, who was involved in the study, told researchers at the European Society of Cardiology conference in Barcelona.

Fuster was also behind the development of polypills for heart conditions, which were available in 2008 but were not approved for commercialization in Spain until 2015. Today, the pills are available in more than 21 other countries.

Physicians are interested to see whether this polypill approach could help make treatment more accessible worldwide.

“The impact this could have on the developing world is important. It simplifies production, distribution and reduces costs,” José María Guerra, a Barcelona cardiologist who was not involved in the study, told Spanish daily El Pais.

Detractors of polypills, however, argue that they are not as flexible when it comes to the personalized medicine approach that sees doctors prescribing more targeted medication to patients.

According to the WHO, over three-quarters of cardiovascular deaths take place in low and middle-income countries.

Cardiovascular diseases are the leading cause of death globally, according to the UN health body.

In 2019, 17.9 million people died from the diseases, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.