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Large research supports cheap combination medicine to reduce heart disease risk



In a large international study, taking four low-cholesterol aspirin cholesterol drugs and antihypertensive drugs daily reduced the risk of heart disease, stroke and heart-related death by nearly one-third, which is expected to cause this “Multi-drug” widely used method.

For more than a decade, doctors have been testing whether cheap, all-in-one combination drugs can make the prevention of heart disease (the world’s number one killer) easier. Friday’s results showed their value, not just for poor countries.

“This applies to all wise countries,”

; said Dr. Salim Yusuf of McMaster University in Hamilton, Ontario. “If rich countries don’t want benefits, it is their privilege.”

He helped lead the research and presented the results at the American Heart Association meeting. They are also published by the New England Journal of Medicine.

At least six companies sell multiple pills outside the United States, including several in Europe, but they are not widely used or sold. Part of the reason why doctors are reluctant is that there is no large international study showing that they can reduce the risk of heart attack and death, not just reduce risk factors such as high blood pressure.

Yusuf said: “I think this will change with our results.”

An independent expert agreed.

Dr. Eugene Yang, a cardiologist at the University of Washington and head of the Cardiology Prevention Group of the American College of Cardiology, said that this research is very important and that “the best data we have so far is about multi-drug .”

He said that in the United States, “I can definitely see” the use of multiple pills in places where there are large differences in health and easy access to care.A small study Proposal to benefit in Alabama last year.

The new study tested Polycap, a medicine from Cadila Pharmaceuticals Ltd. in India that contains three antihypertensive drugs (atenolol, ramipril and “water pill” hydrochlorothiazide) and a cholesterol-lowering drug Statins. Its price in India is about 33 cents per pill.

The researchers recruited more than 5,700 people, mainly in India and the Philippines, as well as Colombia, Canada, Malaysia, Indonesia, Bangladesh, Tanzania and Tunisia. Men must be at least 50 years old, and women must be at least 55 years old. All people have a moderate risk of heart disease due to high blood pressure, diabetes or other diseases.

They were divided into two groups and were given low-dose aspirin (75 mg), polyp medicine alone, polyp plus aspirin or placebo medicine. A group of vitamin D was assigned, but there are no results yet. Before the end of the study, neither the participants nor their doctors knew who was taking what.

The study has been underway for five years, with 7,000 people participating, but drug delivery issues and the coronavirus pandemic have forced researchers to shorten the study time. After an average of only four years, aspirin alone did not change significantly, and only multi-drugs showed a trend of moderate benefit.

However, polyps plus aspirin showed significant value, reducing heart-related problems and deaths by 31%. Approximately 4% of the people in this group died or suffered from one of the heart diseases, while nearly 6% of those taking the placebo.

The side effects are minimal. Yousef said that about 1.5% of multi-drug users have dizziness or low blood pressure, but if this happens, they can switch to a lower dose.

Another expert who did not play any role in this work said: “We now have direct evidence”. These studies have clear and consistent results and there is no safety concern about the value of multidrugs. The Royal Prince of Sydney, Australia Said Anushka Patel, a cardiologist at Fred Hospital.

She said: “The public health impact…may be huge.”

The research was funded by the Wellcome Trust, a British charity. Cadilla Pharmaceuticals; and other public and private research organizations.

Yusuf said multipill companies need regulatory approval to sell the pill in various countries, and generic drugmakers may work with large insurance companies to provide this therapy. He hopes that the Wellcome Foundation, the World Health Federation and the World Health Organization and other steering committees and groups will advocate this approach. Many people have promoted this concept in medical journals.

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The Associated Press Department of Health and Science is supported by the Howard Hughes Medical Institute’s Department of Science Education. AP is solely responsible for all content.


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