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A daily combo pill can boost the cardiovascular health of poor and minority Americans, study suggests

Fighting high blood pressure and cholesterol
A cheap, daily pill that combines four drugs helped low-income Americans reduce their blood pressure and bad cholesterol. Experts say the study may draw U.S. interest to a strategy that has been seen as useful only in places with limited access to medical care.
(Ebrahim Noroozi / Associated Press)

A cheap, daily pill that combines four drugs may help low-income Americans reduce their risk of conditions leading to heart attacks and strokes.

Experts said the study may draw U.S. interest to a prevention strategy that has been seen as useful only in places with limited access to medical care.

The pill contains low doses of three blood pressure drugs and a cholesterol drug.

About 300 people, ages 45 to 75, from a community health center in Mobile, Ala., took part in the study. Half were assigned to take the combo pill. The others continued their usual care.

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After a year, the “polypill” patients had lowered their blood pressure and LDL, or bad cholesterol, by more than the others — and by amounts doctors find meaningful.

“The polypill gives vulnerable patients a running start” toward better health, said study lead author Dr. Daniel Muñoz, a heart doctor at Vanderbilt University Medical Center in Nashville.

The study didn’t last long enough to measure heart attacks or strokes. A five-year study of a different polypill, involving 6,800 people in Iran, found it lowered the danger of heart attack, stroke or heart failure by a third.

Polypills aren’t yet available in the United States. Many U.S. doctors have seen little need, preferring to tailor medications individually, said Dr. Salim Yusuf of McMaster University in Canada, who leads another polypill study expected to finish next year.

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But doctors often fail to customize medications because they don’t have time and patients dislike return visits.

“That just doesn’t happen in practice,” Yusuf said.

The research , funded by the American Heart Assn. and the National Institutes of Health, was published Wednesday in the New England Journal of Medicine.

“This is exactly the type of evidence we need that will help move this strategy forward,” said Dr. Sidney Smith, a former American Heart Assn. president from the University of North Carolina at Chapel Hill who wasn’t involved in the study.

Most people in the study earned less than $15,000 a year, and 96% were black. All had at least borderline high blood pressure. People were excluded from the study if their LDL cholesterol was too high, which would require more aggressive treatment.

Despite having elevated blood pressure, only about half were taking medication for it and less than 20% were on cholesterol medicine.

Vanderbilt made the pills at a monthly cost of $26 per patient, though the drugs were free to study participants.

Charles Roland, 66, of Prichard, Ala., took the polypill. Remembering one pill was easier than his prior routine of a blood pressure pill in the morning and a cholesterol pill in the evening.

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“My blood pressure went way down,” Roland said of his results during the study. “My cholesterol went down and maintained at a consistent level that’s not a threat to my health.”

Johnson writes for the Associated Press.


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