A strategy to reduce cardiovascular disease by more than 80% involves a daily pill containing six components: a statin (e.g., atorvastatin 10 mg or simvastatin 40 mg), three blood pressure lowering drugs (e.g., thiazide, β-blocker, and ACE inhibitor) at half standard dose, folic acid (0.8 mg), and aspirin (75 mg). This combination, called the Polypill, reduces ischaemic heart disease (IHD) events by 88% and stroke by 80%. It is estimated that one-third of people taking the pill from age 55 would benefit, gaining on average about 11 years of life free from an IHD event or stroke. The Polypill has a low risk of adverse effects, with symptoms in 8-15% of people depending on the formulation. The strategy could largely prevent heart attacks and stroke if taken by everyone aged 55 and older and those with existing cardiovascular disease. It is considered safe and would have a significant impact on disease prevention in the Western world. The Polypill targets four major cardiovascular risk factors: low-density lipoprotein cholesterol, blood pressure, serum homocysteine, and platelet function. The strategy is based on evidence from randomized trials and meta-analyses showing that reducing these risk factors significantly lowers the incidence of cardiovascular disease. The Polypill is suitable for people with known cardiovascular disease and for everyone over a specified age (e.g., 55), without requiring risk factors to be measured. The combination of drugs and vitamins in the Polypill is designed to achieve a large effect in preventing cardiovascular disease with minimal adverse effects. The study concludes that the Polypill strategy is a radical but effective approach to prevent cardiovascular disease, as it would prevent more than 80% of IHD events and strokes, with a low risk of adverse effects. The strategy is suitable for widespread use and would have a greater impact on public health in the Western world than any other single intervention.A strategy to reduce cardiovascular disease by more than 80% involves a daily pill containing six components: a statin (e.g., atorvastatin 10 mg or simvastatin 40 mg), three blood pressure lowering drugs (e.g., thiazide, β-blocker, and ACE inhibitor) at half standard dose, folic acid (0.8 mg), and aspirin (75 mg). This combination, called the Polypill, reduces ischaemic heart disease (IHD) events by 88% and stroke by 80%. It is estimated that one-third of people taking the pill from age 55 would benefit, gaining on average about 11 years of life free from an IHD event or stroke. The Polypill has a low risk of adverse effects, with symptoms in 8-15% of people depending on the formulation. The strategy could largely prevent heart attacks and stroke if taken by everyone aged 55 and older and those with existing cardiovascular disease. It is considered safe and would have a significant impact on disease prevention in the Western world. The Polypill targets four major cardiovascular risk factors: low-density lipoprotein cholesterol, blood pressure, serum homocysteine, and platelet function. The strategy is based on evidence from randomized trials and meta-analyses showing that reducing these risk factors significantly lowers the incidence of cardiovascular disease. The Polypill is suitable for people with known cardiovascular disease and for everyone over a specified age (e.g., 55), without requiring risk factors to be measured. The combination of drugs and vitamins in the Polypill is designed to achieve a large effect in preventing cardiovascular disease with minimal adverse effects. The study concludes that the Polypill strategy is a radical but effective approach to prevent cardiovascular disease, as it would prevent more than 80% of IHD events and strokes, with a low risk of adverse effects. The strategy is suitable for widespread use and would have a greater impact on public health in the Western world than any other single intervention.