McMaster researchers say trial suggests common medications cut heart attack, stroke risk in half

Salim Yusuf, professor of medicine at McMaster University, and chief scientist and cardiologist at Hamilton Health Sciences. McMaster University

A recent study driven by data from a pair of Hamilton-based researchers is suggesting a combination of common daily medications can cut a person’s risk of heart attack or stroke in half.

In randomized trials, researchers found that a blend of medications that including aspirin, a blood pressure treatment and a statin — a lipid-lowering medication — reduced the risk of heart attacks by 53 per cent, stroke by 51 per cent, and deaths from cardiovascular causes by 49 per cent, with the greatest protection provided for those over 65.

“This is one of the most important discoveries in three decades when it comes to cardiovascular disease — the number-one killer globally,” said Salim Yusuf, professor of medicine at McMaster, and chief scientist and a cardiologist at Hamilton Health Sciences (HHS).

“Wide use of this simple therapy can prevent between 5 and 10 million individuals experiencing a stroke, heart attack, or dying from these conditions yearly.”

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Philip Joseph, associate professor of medicine at McMaster University and HHS cardiologist, was the principal investigator of the new findings that drew conclusions from three randomized trials involving over 18,000 men and women from 26 countries.

The subjects, who had an average age of 63 and did not have prior cardiovascular disease (CVD), were tracked over a five-year period through campaigns run in 2016, 2019, and 2020 that evaluated the efficacy of a “polypill” — fixed doses combined into a single dose.

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Both Yusef and Joseph have been the leads for a number of recent studies over the last two decades on CVD risk factors around the world.

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In 2019, the two contributed to a report that found more than 70 per cent of CVD cases were tied to 14 modifiable risk factors which included hypertension, abdominal obesity and behavioural factors like smoking, diet, physical activity, alcohol consumption, and salt intake.

“It’s clear the majority of cardiovascular disease cases and deaths are accounted for by a small number of common and modifiable risk factors, these could be improved,” Joseph said after publishing a 2019 paper on CVD risks.

“What is notable is that several risk factors that have a large effect such as strength, low education and indoor and outdoor air pollution have been underappreciated in the past have turned out to be more important than others that we have paid much attention to, such as obesity or salt.”

The concept of a polypill was first proposed 20 years ago as a strategy and precipitated the recent studies developed after a 2001 workshop in London, U.K., with the World Health Organization (WHO).

Yusuf says development of the polypill could potentially lower CVD by 65 to 70 per cent worldwide and reduce the combined costs of various medications.

“The components of a polypill are generic and low-cost to manufacture, and therefore can be available to people at a modest cost,” Yusuf said.

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