Image of different colored pills spilled onto a flat surface

The use of inexpensive combination pills could prevent cardiovascular disease (CVD) on a wide scale, two influential cardiologists write in a commentary published in The Lancet

Although recent studies have shown the effectiveness, safety and affordability of such polypills, which may combine statins, aspirin and blood pressure lowering drugs, “few such combined products are available, and in the few countries where they are available, use is low,” Fausto Pinto, president of the World Heart Federation, wrote.

A ‘global tragedy’

“This systemic failure is a global tragedy, as many premature deaths from CVD could be avoided,” Salim Yusuf, executive director of the Population Health Research Institute and a professor emeritus at McMaster University in Canada, added.

The use of a polypill, also known as fixed-dose combination therapy, was proposed in the early 2000s. Its combination of drugs that target CVD are meant to provide low-cost, widespread prevention at a time when other efforts to do so have only been modestly successful, including in high-income countries, the professors said.

“Even in these countries, fewer than half of patients with prior CVD, and fewer than 20% without prior CVD, receive effective preventive treatments,” Yusuf wrote.

“It is time to use the polypill widely to save millions of lives each year,” Pinto concluded. The two cardiologists recommend the following strategies to expand research on and use of these pills:

  • Encourage large pharmaceutical companies to invest in developing and testing polypills, and newer polypills, in particular, with larger blood pressure-lowering effects.
  • Include polypills in the World Health Organization’s Essential Medicines List, and in guidelines for both primary and secondary prevention of CVD, to encourage clinicians to use them and governments and insurance companies to include them in their formularies.
  • Combine the polypill with lifestyle advice for CVD prevention delivered by trained non-physician healthcare workers.

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