title: [The polypill as cardiovascular prophylactic: clinical trials].
abstract: BACKGROUND
  Cardiovascular disease dominates globally as the most common cause of death. This challenge may be countered by employing a combination pill (the «polypill») for prophylaxis by everybody above a certain age. The polypill normally contains two to three low-dose antihypertensives, a statin and aspirin. Clinical trials with the polypill are reviewed.
  
  
  METHODS
  The databases PubMed and ClinicalTrials.gov were accessed for published, ongoing and planned randomised clinical trials with a polypill, and studies available per June 2013 were identified and evaluated.
  
  
  RESULTS
  Six randomised clinical trials with different variations of a polypill have been published. In these, the polypill has been compared either with placebo (n = 3) or other cardiovascularly active pharmacotherapeutic strategies (n = 3). So far, no data on hard endpoints such as morbidity and mortality are available. On the basis of reductions in blood pressure and cholesterol levels, estimated risk reductions for ischemic heart disease and stroke were in the 33-72% and 21-64% ranges, respectively.
  
  
  CONCLUSIONS
  Additional studies of longer duration and with larger numbers of patients are required to assess the polypill's proposed effects on cardiovascular morbidity and mortality, as well as safety issues.
authors.affiliation: Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet.
authors.forename: Oda Kristine
authors.initials: OK
authors.lastname: Sandli
authors.affiliation: Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet og Avdeling for klinisk farmakologi St. Olavs hospital.
authors.forename: Olav
authors.initials: O
authors.lastname: Spigset
authors.affiliation: Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet og Avdeling for klinisk farmakologi St. Olavs hospital.
authors.forename: Lars
authors.initials: L
authors.lastname: Slørdal
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000187:drug effects; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D012306:Risk
chemical_list: D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D004338:Drug Combinations; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin