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But the magnitude of relative benefit relates to the absolute reduction in blood pressure and LDL-C.

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In people with prior vascular disease aspirin can be beneficial, preventing more events than any bleeds it causes. For chronic disease this is a challenge as you are asking people to take multiple medications every day, for years.

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This in part reflects small difference in blood pressure of 2mmHg recorded. Differences in LDL cholesterol are not reported, just total cholesterol, which is less informative.

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There was also an excess of non-cardiovascular deaths, possibly bleeding-related from other known data. The treatment helps to reduce blood pressure and cholesterol and shows some cardiovascular benefits.

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However, I do not agree that aspirin should be used in the polypill. Instead, perhaps a more potent once-daily, long-acting blood pressure-lowering agent could provide more benefit to patients.

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The press release and article also emphasise the importance of lifestyle interventions and do not just place sole reliance on the polypill. As this was the first large scale trial with a 5-year follow-up it cannot be compared to other studies; im not single im not taken meaning, the claims made appear to be evidence-based within the confines of the trial.

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Despite evidence that drugs can prevent cardiovascular disease in healthy individuals and in people with pre-existing disease, adherence sticking to the therapy as prescribed and persistence continuing the drugs long-term are poor, even in high-income countries.

This is where combining the different component drugs in a single pill the Polypill holds much promise. The research team compared a Polypill once daily to minimal care which involved lifestyle advice in individuals agedin a trial lasting 5 years, making this the longest follow-up study of a Polypill strategy.

The Polypill approach could become part of preventive programmes to reduce cardiovascular disease globally but must not detract from the need for lifestyle change, such as smoking cessation and physical activity.

Future studies should compare the Polypill to the individual drugs taken separately with long-term outcomes, and also consider Polypills in the general population in different countries.

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Declared interests Prof Kausik Ray: Professor Ray receives funding from several pharmaceutical companies developing novel lipid-lowering agents. He is also an investigator on several large-scale trials in lipid-lowering.

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Dr Nicola King: No conflicts of internet.