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Has the polypill finally proven its worth?
  1. Julian Treadwell, DTB Associate Editor
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Julian Treadwell, Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford OX2 6GG, UK; julian.treadwell{at}phc.ox.ac.uk

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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 …

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