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A new three-in-one-pill could reduce the risk factors for heart disease and stroke by 50 per cent and revolutionize prevention of these medical conditions, which kill thousands of Canadians every year, according to a study released yesterday.

The study, published in the Lancet, showed that when blood-pressure medications, Aspirin and cholesterol-lowering medication were taken together in one pill, known as the Polycap, they were just as effective as when taken separately.

"People could take a pill a day and, literally, keep the doctor away," said Salim Yusuf, a cardiologist and the study's lead author.

The Polycap contains the dosage of a baby Aspirin, three different blood-pressure-lowering drugs (atenolol, ramipril and thiazide) and the generic version of a statin drug, which lowers cholesterol.

One pill is easier for patients to remember to take, cheaper to manufacture and less onerous for doctors to prescribe, says Dr. Yusuf, head of the Population Health Research Institute at McMaster University in Hamilton.

The study also found there were fewer side effects than when the drugs, which lower blood pressure, heart rate and cholesterol, and suppress clotting, are taken separately.

"You can put these pills together and they work," Dr. Yusuf said.

The Lancet study shows the Polycap, also known as the polypill, passed the first hurdle. But researchers must now assess whether it reduces the incidence of heart attacks and strokes.

"That is the billion-dollar question," said Dr. Yusuf, noting there are already clinical trials under way. "The theory is, the degree to which these risks are lowered should lead to the halving of incidents of strokes and heart attacks."

The Lancet study was conducted on 2,053 people in India between the ages of 45 and 80. Participants had at least one risk factor for heart disease, including Type 2 diabetes, obesity, high blood pressure, smoking or high cholesterol.

Four hundred people were given the polypill for three months; the others took one of the individual components, or a combination of several.

The polypill lowered blood pressure about as much as blood-pressure drugs taken alone. Bad cholesterol declined 23 per cent on the polypill, versus 28 per cent in those who took the statin separately. Anti-clotting effects were about the same for those on the polypill and those who took only Aspirin.

Collectively, the results show that the polypill reduces the risk of heart disease by 62 per cent and of stroke by 48 per cent.

Dr. Yusuf said the polypill, which is not yet on the market, could cost as little as $1 a capsule, and one tenth of that in the developing world. The experimental medication is made by Cadila Pharmaceuticals in Ahmedabad, India, which also funded the study.

The medical community reacted with optimism to the Lancet paper. However, physicians also cautioned against the idea of a "magic bullet."

"If you are born rich, you will have less of a chance of dying from cardiovascular disease," said Joel Lexchin, a professor of health policy at York University, and an emergency-room physician. "But you also need to concentrate on lifestyle factors you can modify, such as diet, exercise and smoking."

He questioned the wisdom of giving people with only one medical issue a pill to address others. As well, there are concerns about the inability to change the dosages of the different components in the polypill.

"Blood pressure medication, for example, often requires a lot of fiddling," said Dr. Lexchin, who added that the polypill may be a worthwhile alternative for those already taking all five medications.

After cancer, heart disease is the second most common and stroke the third most common cause of death in Canada.