Cut Stroke in Half: Polypill for primary prevention in stroke
The aim of this project is to evaluate the potential of a cardiovascular polypill containing blood pressure and cholesterol lowering medication in combination with lifestyle interventions for the primary prevention of stroke.
Stroke is one of the leading causes for death and disability globally. In 2011, The United Nations (UN) recognised NCDs (including stroke) as a major challenge for the 21st century and endorsed a global action plan for a relative reduction in risk of premature mortality from NCDs by 25% in 2025.
As much as 90% of population risk of stroke can be attributed to potentially modifiable risk factors such as hypertension, smoking, obesity, unhealthy diet, low physical activity, diabetes, high cholesterol, alcohol consumption and air pollution. Therefore medical treatment in conjunction with lifestyle modification may be the optimal therapy for stroke prevention to achieve the NCD goals.
A cardiovascular fixed-dose combination polypill, combining several medications which are used in clinical practice for CVD risk reduction (e.g. blood pressure and lipid lowering medications, aspirin) simplifies the intake and increases thereby compliance. A distribution of such a polypill at low or no costs in a population with a high prevalence of untreated risk factors and no or difficult access to medical care in adjunction to lifestyle intervention (regular physical activity, healthy diet, no smoking) may lower stroke risk by 50%.
WORKSHOP „Is the POLYPILL useful for stroke prevention?’’
A scientific workshop took place in May 2017 at the Department for Clinical Neurosciences and Preventive Medicine. All participants were international experts in stroke care and epidemiology: Michael Brainin (Austria); Valery Feigin (New Zealand); Sheila Martins (Brasilia); Karl Matz (Austria); Jayanta Roy (India); Peter Sandercock (United Kingdom); Jaakko Tuomilehto (Finland, Kuwait); Anita Wiseman (United Kingdom).
The presentations and discussions from this workshop summarised the potential of the Polypill for stroke prevention in low and middle income countries and were consequently published (Brainin M, Feigin V, Martins S, Matz K, Roy J, Sandercock P, Teuschl Y, Tuomilehto J, WisemanA. Cut Stroke in Half: Polypill for primary prevention in stroke. Int J Stroke, in press).
The cornerstones and the feasibility of a randomised trial testing the efficacy of a polypill in combination with lifestyle interventions compared to placebo and usual care to avoid or delay stroke are currently being discussed with international experts. The aim is to conduct this study with the support of the World Stroke Organisation (WSO) in the near future.