Background: Most individuals at high cardiovascular disease (CVD) risk worldwide do not receive any or optimal
preventive drugs. We aimed to determine whether fixed dose combinations of generic drugs (`polypills?) would promote
use of such medications.
Methods: We conducted a randomized, open-label trial involving 623 participants from Australian general practices.
Participants had established CVD or an estimated five-year CVD risk of 15 , with indications for antiplatelet, statin and
2 blood pressure lowering drugs (`combination treatment?). Participants randomized to the `polypill-based strategy?
received a polypill containing aspirin 75 mg, simvastatin 40 mg, lisinopril 10 mg and either atenolol 50 mg or hydrochlorothiazide
12.5 mg. Participants randomized to `usual care? continued with separate medications and doses as prescribed
by their doctor. Primary outcomes were self-reported combination treatment use, systolic blood pressure and total
Results: After a median of 18 months, the polypill-based strategy was associated with greater use of combination
treatment (70 vs. 47 ; relative risk 1.49, (95 confidence interval (CI) 1.30 to 1.72) p