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Polypills, fixed-dose tablets containing combinations of drugs for cardiovascular disease prevention, enjoyed much hype in the early 2000s including one projection of a possible 88% relative risk reduction in ischaemic cardiac events.1 However, as an editorial in Drug and Therapeutics Bulletin noted in 2009 evidence was lacking on their effect on hard outcomes, despite short-term trials showing improvements in surrogate markers, such as blood pressure and cholesterol.2 3 The results of the first long-term randomised controlled trial were published in August this year prompting media headlines about a ‘four-in-one pill to prevent a third of heart problems’.4 So, has the polypill’s time come at last?
The PolyIran trial a collaboration between the universities of Tehran and Birmingham, compared a once-daily polypill (hydrochlorothiazide 12.5 mg, aspirin 81 mg, atorvastatin 20 mg and enalapril 5 mg) plus lifestyle advice with lifestyle advice alone.5 The setting was a rural …
Competing interests None declared. Disclosure of conflicts of interest form is published online as a supplementary file.
Provenance and peer review Commissioned; externally peer reviewed.