“Polypills” Are Broadly Effective for Primary Cardiovascular Disease Prevention in Patients with Excess Risk

“Polypills” — fixed-dose pills that contain two or more blood pressure–lowering medications plus a statin, with or without aspirin — have improved adherence and lowered composite adverse cardiovascular (CV) outcomes in several primary prevention trials (e.g., NEJM JW Gen Med Oct 1 2019 and Lancet 2019; 394:672). To better understand the effects of polypills, researchers combined individual patient data from three large randomized primary prevention trials (>18,000 participants, most at intermediate CV risk) in which polypills were compared with placebo or usual care.

After a median follow-up of 5 years, the primary outcome (i.e., CV-related death, myocardial infarction, stroke, or arterial revascularization) occurred significantly less frequ…