The “polypill” once again made headlines recently when the results of a study by Doctor Salim Yusuf were presented at the American College of Cardiology meeting in Orlando on March 30, 2009.

The concept of a polypill began in 2003 when Doctors Wald and Law published a paper in the prestigious British Medical Journal. They proposed to create a hypothetical pill containing six cheap, generic components that would lower blood pressure, lower cholesterol and decrease platelet activity. Each individual component had multiple studies showing that it was associated with a decrease in cardiac events and a decrease in mortality. Using epidemiologic models they showed that a daily polypill could reduce heart attacks and strokes by 88% and add 11 years to the average lifespan.

Since then there have been additional studies examining the theoretical benefits of such an approach, but Dr. Yusuf presented the first actual results of a clinical trial with a polypill (called a polycap in his study) in actual patients.

The Indian Polycap Study (TIPS) was a phase II double blind study of 2053 patients aged 45 to 80 without known heart disease randomized to a polycap (thiazide 12.5 mg, atenolol 50 mg, ramapril 5 mg, simvastatin 20 mg and aspirin 100 mg) daily versus each individual component. The patients were followed for 12 weeks and those on the polycap had lower blood pressure, lower cholesterol and lower platelet activity than those in the other arms of the study. Additionally, the side effects in the polycap arm were the same as in the other arms of the study. Based on epidemiologic data the author concluded that long term daily use of the polycap would reduce heart disease incidence by 80%.

The polycap will be commercially available (Cadila Pharmaceuticals) in India within a few months but will require years of FDA mandated testing before becoming available to American consumers.