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Polycap Reduces CVD Risk

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Polycap Reduces CVD Risk RESEARCH HIGHLIGHTS PREVENTION Polycap reduces CVD risk A polypill that contains three blood recruited 2,053 individuals aged pressure lowering agents, aspirin and a between 45 and 80 years, who had statin in low doses has the potential to one cardiovascular risk factor but no reduce the incidence of cardiovascular previous CVD. The Polycap (Cadila disease (CVD) by 62% and stroke by Pharmaceuticals, Ahmedabad, India) 48%, according to the investigators of the contains 12.5 mg hydrochlorthiazide, Indian Polycap Study (TIPS). 50 mg atenolol, 5 mg ramipril, 20 mg simvastatin and 100 mg aspirin. …replacing multidrug Participants were randomly assigned to regimens with a single pill could receive the Polycap, or another single ‘‘ capsule containing one of eight different simplify risk factor reduction… combinations of Polycap constituents, once daily for 12 weeks. This design was The concept of a polypill was first ’’ used to investigate whether the Polycap proposed in 2003 by Wald and Law, was as effective as the additive effect of be more effective in high-risk individuals, who estimated that more than 80% of each constituent drug given separately. such as those with diabetes, than in cardiovascular events could be prevented The investigators found that mean those with fewer risk factors for CVD. if such a polypill was taken by every blood pressure reduction was similar The Polycap was well tolerated and there adult over the age of 55 years and by all among individuals who received were no differences in the number of patients with known CVD. The agents the Polycap (7.4 mmHg systolic and drug-related adverse events between the used in such a polypill have proven 5.6 mmHg diastolic) and those given a treatment groups. efficacy for reducing CVD risk when used capsule containing three blood pressure The promising results from TIPS have individually, but “many people find that lowering agents (6.6 mmHg systolic and laid the groundwork for future research taking several pills every day, some more 4.8 mmHg diastolic), but greater than on the Polycap. “The next step is to carry than once a day, for an indefinite period in those taking only one (2.2 mmHg out a long-term clinical trial evaluating the [is] burdensome” explains Professor systolic and 1.3 mmHg diastolic) or effect of the polypill in reducing the risk Koon Teo, one of the authors of TIPS. two (4.7 mmHg systolic and 3.6 mmHg of major vascular events,” says Professor “Many do not take the medications diastolic) drugs. By contrast, participants Teo. Assuming the findings from TIPS are at all, or gradually stop taking them, who received a capsule containing confirmed, the concept of a polypill will particularly if they do not have symptoms.” simvastatin alone, derived greater benefit have a huge effect on clinical practice. The investigators believe that replacing in terms of lowering LDL cholesterol Alexandra King multidrug regimens with a single pill could than did those who took the Polycap simplify risk factor reduction and improve (0.83 mmol/l versus 0.70 mmol/l). Heart Original article The Indian Polycap Study (TIPS). Effects patients’ adherence to medication. rate was reduced to a similar extent in of a polypill (Polycap) on risk factors in middle-aged TIPS was a multicenter, double-blind, the groups who received the Polycap individuals without cardiovascular disease (TIPS): a randomized, proof-of-principle trial and atenolol alone (7 bpm). A subgroup phase II, double-blind, randomised trial. Lancet 373, 1341–1351 (2009). conducted in India. The researchers analysis indicated that the Polycap might NATURE REVIEWS | CARDIOLOGY VOLUME 6 | JUNE 2009 | 386 © 2009 Macmillan Publishers Limited. All rights reserved.
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