BMJ  2003;326 (28 June), doi:10.1136/bmj.326.7404.0

Pill could reduce cardiovascular disease considerably

Taking a single combination pill daily could reduce the incidence of cardiovascular disease by over 80%. In the first of three articles in this issue, Wald and colleagues (p 1419) present the concept of combining six active components in one pill (the Polypill) taken every day from age 55, or sooner if people have a diagnosis of cardiovascular disease or diabetes. They argue that the combination of a statin, a thiazide, a blocker, an angiotensin converting enzyme inhibitor, folic acid, and aspirin simultaneously reduces four key cardiovascular risk factors: low density lipoprotein cholesterol, blood pressure, serum homocysteine, and platelet function. The authors' systematic review and meta-analysis of over 200 studies (p 1423) shows that the use of statins can lower low density lipoprotein cholesterol by 1.8 mmol/l, which could decrease the risk of ischaemic heart disease by 60% and stroke by 17%. Their examination of 354 randomised controlled trials (p 1427) found that giving drugs at half the standard dose can significantly lower blood pressure with minimal adverse effects, which in turn reduces the risk of stroke by 63% and ischaemic heart disease by 46%. In an accompanying editorial, Rodgers (p 1407) says that the Polypill may have enormous potential for preventing cardiovascular disease, including in developing countries.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

"Polypill" to fight cardiovascular disease: Birthday present was much appreciated

Felipe Ramos
BMJ 2003 327: 808. [Extract] [Full Text]

Time has come for a medical minister of health

Ian H Kunkler
BMJ 2003 327: 291. [Extract] [Full Text]

Co-proxamol and suicide: Co-proxamol should be restricted, not banned

Ivan L Marples
BMJ 2003 327: 287. [Extract] [Full Text]

Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials

M R Law, N J Wald, J K Morris, and R E Jordan
BMJ 2003 326: 1427. [Abstract] [Full Text] [PDF]

Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis

M R Law, N J Wald, and A R Rudnicka
BMJ 2003 326: 1423. [Abstract] [Full Text] [PDF]

A strategy to reduce cardiovascular disease by more than 80%

N J Wald and M R Law
BMJ 2003 326: 1419. [Abstract] [Full Text] [PDF]

A cure for cardiovascular disease?

Anthony Rodgers
BMJ 2003 326: 1407-1408. [Extract] [Full Text] [PDF]