How often do you forget to pop that pill to control your shooting blood pressure? Or skip the aspirin tablet that could have prevented a stroke at night? Not anymore. For the first time, doctors and researchers have come up with a single pill for all cardiovascular diseases (CVD), including high blood pressure and vulnerability to stroke, doing away with the pain of popping multiple pills to keep your heart healthy. Trials for this new pill – called the polypill – across Europe and India have proved successful, according to a study published on Wednesday in the Journal of the American Medical Association. As many as 28 Indian institutes, including AIIMS, PGIChandigarh and George Institute for Global Health- India worked together as part of the study, planned by London’s Imperial College.

The formulation for the drug was done by Dr Reddy’s Laboratories. “Most patients with high BP require multiple drugs to keep it under control. This raises the problem of compliance over a prolonged period as patients often forget to take some of the pills. In India, compliance to multiple pills for CVD is as low as 10%. Polypill will take care of it,” said Dr Vivekanand Jha, executive director of George Institute for Global Health-India. While studies have shown that patients with CVD do not take recommended medications in the long-term, the use of fixed-dose combinations (FDCs) like a polypill improves adherence to a large extent.

The study showed adherence rate increasing by 20% with use of the polypill, a combination of aspirin, statin (cholesterol lowering drugs), and two blood pressurelowering agents. Funded by the European Commission’s Seventh Framework Program, the study has shown evidence, for the first time, about the risks and benefits of the single pill. As many as 2,004 people, in the mean age of 62 and with high risk of CVD, initially participated in the study in India and across Europe between July 2010 and July 2011. The trial follow-up concluded in July 2012. Previous trials have assessed short-term effects. At the end of the study on 1921 of the participants, conducted for an average 15 months, it was found that 829 (86.3%) of the 961 participants who were administered the polypill continued with it.

In comparison, only 621 (64.7%) of the 960 participants continued with multiple pills as prescribed. But the study showed one limitation: If any of its components led to some adverse effect, the polypill had to be discontinued. The study involved the Imperial College, London’s International Centre for Circulatory Health, The George Institute for Global Health-India, Centre for Chronic Disease Control, New Delhi, Royal College of Surgeons in Ireland, Dublin; Julius Center for Health Sciences and Primary Care, Utrech; Public Health Foundation of India, New Delhi and The George Institute for Global Health, Sydney. “These new findings dispel several myths about the polypill. Despite the use of older medications and fixed doses, the polypill group improved blood pressure and cholesterol levels simply because those surevyed took recommended medications more regularly,” said Prof D Prabhakaran, executive director of the Centre for Chronic Disease Control.

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