A low-priced pill which contains four different drugs is effective in preventing heart disease and strokes, a study has claimed.
Coronary heart disease and stroke are the top two causes of death worldwide, killing more than 15 million people a year.
The results were studies for over five years and compared with those with lifestyle advice alone in the first large randomised trial of its kind involving nearly 7,000 individuals aged 50-75 years in Iran.
The research was carried out in a collaboration between the University of Birmingham, Tehran University of Medical Sciences in Iran, Golestan University of Medical Sciences in Iran, Morgan State University in the USA, Isfahan University of Medical Sciences in Iran, Icahn School of Medicine in the U.S. and the National Cancer Institute also in the US.
The trial by Tehran University of Medical Sciences in Iran, involved 6,841 people aged 55 and over who were living in 236 villages in northern Iran.
The benefits were as high as 57% among volunteers who remembered to take the pill regularly.
About one in 10 had previously had heart attacks, strokes or other cardiovascular episodes.
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The polypill led to large reductions in bad cholesterol but had only a slight effect on blood pressure, the study showed. Others were given healthy lifestyle advice alone. Over that time, 202 people taking the polypill had a major cardiovascular event, such as heart attack, heart failure, or stroke, compared with 301 in the "advice" group.
Compared with lifestyle advice, taking the polypill reduced the risk of major cardiovascular events by 34% overall-and by around 40% in individuals without a history of CVD over five years (136/3,033 [4.5%] vs 229/3,068 [7.5%]), and by approximately 20% in those with previous CVD (66/388 [17%] vs 72/349 [21%]). The effects were similar in both men and women and the old and young.
"Now we know that a fixed-dose polypill can achieve clinical benefits in practice", Malekzadeh said in a statement.
"But the polypill is not an alternative to a healthy lifestyle and should be combined with physical activity, a healthy diet, and smoking cessation".
It has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income and middle-income countries.
Professor KK Cheng, director of the Institute of Applied Health Research at the University of Birmingham, added: "A polypill strategy could also work in other countries, particularly those where cardiovascular diseases are still increasing".