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The polypill: a magic bullet against cardiovascular disease?

Promising in high risk populations, but perhaps not

  • By: Emma Wallace, Tom Fahey
  • Published: 01 October 2012
  • DOI: 10.1136/sbmj.e6386
  • Cite this as: Student BMJ 2012;20:e6386

Cardiovascular disease remains the leading cause of mortality in developed countries, and has been described as a “global epidemic.”1 In 2003, Wald and Law proposed a new polypill: six drugs combined into one tablet that would work to reduce cardiovascular risk. They proposed the polypill as a way of targeting modifiable cardiovascular risk factors, both for adults with pre-existing cardiovascular disease (secondary prevention) and, more controversially, for adults over 55 years old without cardiovascular disease (primary prevention).2

Wald and Law argued that over 80% of myocardial infarctions and strokes could be prevented if this strategy was adopted. The polypill would contain six ingredients: three blood pressure lowering drugs (a thiazide diuretic, a β blocker, and an angiotension converting enzyme (ACE) inhibitor), a statin, aspirin, and folic acid. Their idea ignited great debate in the medical community regarding its potential to reduce the global burden of cardiovascular disease. The polypill has

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