“Despite substantial scientific evidence of the high effectiveness, safety, and affordability of the polypill, few such combined products are available, and in the few countries where they are available, use is low,” says Professor Fausto Pinto, President of the World Heart Federation. “This systemic failure is a global tragedy, as many premature deaths from CVD could be avoided,” says Professor Salim Yusuf, Executive Director of the Population Health Research Institute (PHRI) and Professor Emeritus of Medicine at McMaster University. Every year, about 54 million individuals suffer from cardiovascular disease; one-third of them die as a result of CVD, with 80 percent of them residing in low- and middle-income countries. Most heart attacks and strokes occur in patients who have never had CVD, implying that primary prevention of the first heart attack or stroke is important. Secondary prevention is also important for individuals who already have CVD, although it does not have the same impact. “The current strategy for primary and secondary prevention of CVD has only been modestly successful in most countries, including high-income countries. Even in these countries, fewer than half of patients with prior CVD, and fewer than 20% without prior CVD, receive effective preventive treatments,” says Professor Yusuf. The polypill, also known as fixed-dose combination (FDC) therapy – with the combination of blood pressure lowering agents, a statin for lowering LDL cholesterol, and low-dose aspirin – was proposed in the early 2000s as a means to reduce CVD substantially and at low cost. “The answer is now clear and resounding, with data from three independent, large, and long-term trials in primary prevention and one in secondary prevention showing its life-saving significance,” says Yusuf, whose various publications have shown that heart attacks and strokes were cut by 35 to 50 percent by using a polypill. “It is time to use the polypill widely to save millions of lives each year,” says Professor Pinto. He and Professor Yusuf recommend the following new strategies: Reference: “The polypill: from concept and evidence to implementation” by Salim Yusuf and Fausto J Pinto, 12 October 2022, The Lancet.DOI: 10.1016/S0140-6736(22)01847-5
