Sammanfattning
BACKGROUND: Cardiovascular disease dominates globally as the most common cause of death. This challenge may be countered by employing a combination pill (the «polypill») for prophylaxis by everybody above a certain age. The polypill normally contains two to three low-dose antihypertensives, a statin and aspirin. Clinical trials with the polypill are reviewed.
METHOD: The databases PubMed and ClinicalTrials.gov were accessed for published, ongoing and planned randomised clinical trials with a polypill, and studies available per June 2013 were identified and evaluated.
RESULTS: Six randomised clinical trials with different variations of a polypill have been published. In these, the polypill has been compared either with placebo (n = 3) or other cardiovascularly active pharmacotherapeutic strategies (n = 3). So far, no data on hard endpoints such as morbidity and mortality are available. On the basis of reductions in blood pressure and cholesterol levels, estimated risk reductions for ischemic heart disease and stroke were in the 33 - 72 % and 21 - 64 % ranges, respectively.
INTERPRETATION: Additional studies of longer duration and with larger numbers of patients are required to assess the polypill’s proposed effects on cardiovascular morbidity and mortality, as well as safety issues.