Jackie Bosch

People 65 years or older who have vascular risk factors – such as obesity, smoking, high blood pressure, and diabetes – experienced less decline in function (the ability to do everyday tasks) by taking polypills, a PHRI-led study has found.

“We found a significant slowing of functional decline among individuals randomly assigned to receive the polypill,” says PHRI Investigator Jackie Bosch, first author of the study in JAMA Neurology.

A total of 2389 older adults (60% female) underwent 5 years of polypill treatment – antihypertensives and statin medications combined in a single pill – at 86 hospitals and community-based centres in the Philippines, India, Colombia, Canada, Bangladesh, Malaysia, Tunisia, and Indonesia.

Measures of functional status of patients – including social activities of daily living, attention, memory and ability to switch between tasks, mobility, and organizing activity such as shopping or doing finances and the like –  “may better reflect covert cerebrovascular damage, and are more clinically meaningful to patients compared with cognitive test score,” Bosch adds. The study did not find an effect on cognition by treating patients with vascular risk factors with polypills.

“Our findings emphasize the importance of extending outcomes in cardiovascular trials to routinely include measures of functional status,” says PHRI Executive Director Salim Yusuf, senior author on the study.

Salim Yusuf

Yusuf notes the new findings add to the evidence-based benefits of polypills accrued from several large, global RCTs, including the the TIPS-3 randomized clinical trial of which this latest study was a subset.

TIPS-3 (NEJM, 2020) found that the polypill could cut heart attacks and strokes by up to 40%.

“These new findings increase our call to action for next steps to implement the polypill globally – for not only does the polypill prevent cardiovascular events and death, it also improves function in older adults with vascular risk factors,” says Yusuf.

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