RESEARCH HIGHLIGHTS THERAPY A step towards a single pill for cardiovascular disease prevention A combination pill (Polypill) that receive Polycap (n = 412)—three agents although not significantly different with contains blood-pressure-lowering to lower blood pressure, a statin and Polycap or aspirin alone, did not meet drugs at low doses, plus a statin, aspirin aspirin—or to eight other groups (each the prespecified noninferiority standard. and folic acid could drastically reduce of ~200 individuals) that received only Encouragingly, tolerability of Polycap did cardiovascular disease if taken by certain components of Polycap. Study not seem to be worse than that of its active individuals ≥55 years, irrespective of their drugs were taken for 12 weeks. component drugs. risk factors or history of cardiovascular The results highlight that the effects disease, according to theoretical of a Polypill cannot be assumed to be projections. The Indian Polycap Study Projected reductions in equivalent to the effects of its individual by Yusuf and co-investigators was a cardiovascular disease events components taken separately. Projected phase II, double blind, randomized trial with‘‘ Polycap were 50–60% reductions in cardiovascular disease of one such Polypill: Polycap (Quintapill®, events with Polycap were 50–60%, less Cadila Pharmaceuticals India, India). ’’ than previous estimated effects of a The researchers aimed to examine the Polycap was noninferior to its Polypill, but, nevertheless, substantial. effect of Polycap on blood pressure, lipids, individual components for blood-pressure Further trials will be needed to reveal if heart rate and urinary thromboxane B2 lowering and heart-rate reduction. For a Polypill strategy is safe and effective and to determine whether the effects of example, blood pressure was reduced to long-term. Polycap were noninferior to those of its a similar extent in the Polycap group and Carol Wilson equivalent components. the group assigned to the three blood- The trial, conducted in India, included pressure-lowering agents, with or without Original article Indian Polycap Study (TIPS) et al. Effects 2,053 individuals without cardiovascular aspirin. However, reductions in LDL of a polypill (Polycap) on risk factors in middle-aged disease, aged between 45 and 80 years, cholesterol with Polycap were less than individuals without cardiovascular disease (TIPS): who had one cardiovascular risk factor. those with the statin given alone, and a phase II, double-blind, randomised trial. Lancet 373, 1341–1351 (2009). Participants were randomly allocated to reductions in urinary thromboxane B2, NATURE REVIEWS | ENDOCRINOLOGY VOLUME 5 | AUGUST 2009 | 416 © 2009 Macmillan Publishers Limited. All rights reserved.