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‘Polypill’ recommended to reduce heart attacks and strokes, but it will take time to gain support

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It was long ago shown that taking a single pill containing a combination of drugs that target symptoms related to cardiovascular disease lowers the risk of death from causes such as heart attack and stroke. The concept of using such “polypills” for the prevention and treatment of atherosclerotic cardiovascular disease was introduced almost 25 years ago. Shortly thereafter, this strategy became the focus of semen modeling studies promoting polypills to reduce cardiovascular disease at a population level. Yet, even after many years and a body of supporting research, the use of such pills remains low around the world.

Now, a new study by researchers at Washington University School of Medicine in St. Louis reinforces previous findings and shows that the polypill prevents heart attacks and strokes and reduces death in people with cardiovascular risk factors such as high blood pressure and high blood pressure. provides additional evidence that it is beneficial in reducing cholesterol. As a result of research, the World Health Organization (WHO) has added such polypills to its updated model list of essential medicines. This list includes medicines that are considered key to public health because of their importance, safety, efficacy, and cost-effectiveness in treating common diseases.

The study was published in the journal Nature Medicine.

“The main takeaway here is that the polypill is effective,” said lead author Anubha Agarwal, MD, assistant professor of medicine in the cardiovascular division. “And if the polypill were widely accepted and used to prevent cardiovascular disease, we would be in a far better position to equitably reduce the impact of cardiovascular disease around the world. Simplifying options and replacing multiple drugs with a single pill has the potential to expand access beyond economic levels around the world due to its potential affordability.”

Researchers performed a systematic analysis of data collected from 26 clinical trials. This data synthesizes the efficacy of polypills in preventing atherosclerotic cardiovascular disease. To be included in the analysis, trials had to evaluate polypills containing at least one statin (cholesterol-lowering drug) and at least one blood pressure-lowering drug.

The analysis found that polypills had an 11% lower risk of death from any cause compared to people who did not take the polypill, and an 11% lower risk of atherosclerotic cardiovascular disease events compared to people who did not take the polypill. was found to be associated with 29% lower

“These findings support the adoption and implementation of the polypill to reduce the risk of all-cause mortality from cardiovascular disease,” Agarwal said.

Researchers also found that polypill use was associated with lower low-density lipoprotein (LDL) cholesterol and lower systolic blood pressure. Systolic blood pressure is the first number in a blood pressure measurement that shows the pressure in the blood vessels when the heart beats. Some people who have used Polypill have experienced side effects such as muscle pain and cough.

Agarwal and his colleagues called for data to determine whether widespread use of the polypill should be encouraged to prevent cardiovascular disease. This review was the basis for the research team’s successful application to the WHO to include the polypill on the WHO’s 23rd Model Essential Medicines List for the primary and secondary prevention of high-risk cardiovascular diseases.

WHO approval could increase the willingness of governments and international organizations to fund such polypills and encourage health care providers to prescribe them. Agarwal said the decision could ultimately improve global access to the polypill, especially in low- and middle-income countries.

Agarwal said one reason polypills have not been widely adopted is that companies have no incentive to invest in producing polypills, including generic drugs, even though the potential benefit to public health is large. Ta.

“The field of polypills will continue to evolve,” said Mark D. Huffman, MD, lead author of the study and professor of medicine. “The next challenge is to learn how to best implement and sustain the use of the polypill to prevent millions of heart attacks and strokes each year.”

Agarwal A, Mehta PM, Jacobson T, Shah NS, Ye J, Zhu J, Wafford QE, Bahir E, de Kates AN, Ebrahim S, Prabhakaran D, Rogers A, Huffman MD. Fixed-dose combination therapy to prevent atherosclerotic cardiovascular disease. natural medicine. March 26, 2024.

This study received no funding. Agarwal is supported by the National Institutes of Health (NIH) under grant number K99HL157687. Grant Number 2020144 from the Doris Duke Charitable Foundation.

Agarwal and Huffman have a patent pending on their heart failure polypill. Mr. Huffman will be based at the George Institute for Global Health in Sydney, Australia. The Institute holds patents and licenses and has also received investment funding to commercialize fixed-dose combination therapy through its social enterprise business, George Medicines.

About the University of Washington School of Medicine

WashU Medicine is a world leader in academic medicine, including biomedical research, patient care, and education programs with 2,900 faculty members. The National Institutes of Health’s (NIH) research funding portfolio is the second largest among U.S. medical schools and has increased by 56% over the past seven years. Combined with institutional investments, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. His faculty practices are consistently among the top five in the nation, with more than 1,900 faculty physicians practicing at his 130 locations and on the medical staff at BJC Healthcare’s Barnes-Jewish Hospital and St. Louis Children’s Hospital. WashU Medicine has a storied history in MD/PhD training, recently investing $100 million in scholarships and curriculum updates for medical students, offering training in all medical subspecialties, as well as physical therapy, occupational therapy, and audiology. We offer some of the best training programs in the field. and communication science.

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