POLYIRAN Study

Atherosclerotic events (e.g. myocardial infarction and stroke) are the top causes of mortality in Iran and many other countries. Preventing such events requires early detection and timely correction of risk factors such as hypertension or hyperlipidemia. The current practice is medical evaluations at regular intervals after a certain age. Such an approach, when preformed for the whole population, requires resources which might not be readily available even in developed countries. One other approach is to treat everyone older than a certain age with a cheap single-dose combination of low dose anti-risk factor medicine (PolyPill). There is growing evidence that such an approach, in theory, might prevent up to 80% of the mortality from atherosclerotic events. The PolyIran study is designed to evaluate the effect of a single-dose fixed-combination pill (PolyPill) in preventing atherosclerotic events in the general population above 50 years old. The polypill consists of 80 mg aspirin, 5 mg enalapril, 20mg atorvastatin and 12.5mg hydrochlorothiazide. This is an open-labeled study including 7,000 subjects randomized to receive either polypill once daily or no treatment. The subjects will be followed for 5 years and all-cause mortality and atherosclerotic events will be recorded. Subjects are randomly selected from the Golestan Cohort Study running in North Iran.