CANADA: Super pill could slash heart attacks and strokes

. Daily dose combines five different medicines CALGARY, Alberta / Calgary Herald / Health / Seniors / March 31, 2009 By Sharon Kirkey, Canwest News Service Canadian researchers say a single, daily pill combining five medicines could potentially cut by half the number of heart attacks and strokes in middle-aged people. The pill--called Polycap --is a cocktail of three blood-pressure-lowering drugs(thiazide, atenolol and ramipril), Aspirin to reduce clotting and simvastatin, a cholesterol-lowering drug. In tests of more than 2,000 people in India, each component of the pill did what it was supposed to do, and there was no evidence of increasing side-effects with five active components in one pill. The 12-week study wasn't designed to see whether the "polypill" actually reduced heart attacks, stroke and death. That requires a bigger study with longer followup. But the findings suggest the pill could potentially reduce cardiovascular heart disease by 62 per cent and stroke by 48 per cent, researchers from McMaster University in Hamilton and St. John's Medical College in Bangalore, India, write in the journal The Lancet. The study was presented Monday at the American College of Cardiology meeting in Florida. Heart disease is the leading cause of death worldwide. The study is a "first and crucial step" toward realizing the dream of combining several different drugs into one pill to treat many of the cardiac risk factors, says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston and an associate professor of medicine at Harvard Medical School. "We're not all the way there yet. We do need a larger study. . . . But it's a big step toward having a simple pill that could provide this broad cardio-protection to tens of millions of people worldwide." Polycap is manufactured by Cadila Pharmaceuticals in India, which paid for the study. The five ingredients in the pill are available in generic form. Cannon estimates the polypill would cost about $20 a month. In an accompanying commentary, he worries the availability of a "single magic bullet" for the prevention of heart disease could lead people to think popping a pill would solve all their problems. "The worry, of course is, would they just take this and sit in front of a TV and not exercise and gain even more weight?" The study involved 2,053 people, ages 45 to 80, without cardiovascular disease but with one risk factor for it, such as hypertension, obesity, high cholesterol, diabetes or smoking. Participants were randomly assigned to get Polycap (412 people) or to one of eight other groups testing different combinations of the drugs. Polycap lowered blood pressure, heart rate, cholesterol and the clotting ability of the blood "in the same way as if I were taking the (five) pills separately," says Dr. Koon Teo, professor of medicine at McMaster and a cardiologist at Hamilton Health Sciences. The team says the drop in blood pressure with Polycap could theoretically lead to about a 24 per cent lower risk of heart disease and a 33 per cent lower risk of stroke in people with average blood pressure levels. Cannon says the major appeal of the polypill is its simplicity. "It's obviously simpler to take one pill than to remember, this one has to be taken twice, this one has to be taken once in the morning and whatnot." But the concept is controversial: critics have warned giving a polypill to everyone, or people at only moderate risk of heart disease, could sap health budgets, expose healthy people to the risk of side-effects and "medicalize" a large proportion of the population. © Copyright (c) The Calgary Herald