A combination pill containing aspirin, a statin, three anti-hypertensives and folic acid was proposed in 2003 after calculations suggested it could save lives if given to all over-55s.
Research based on data from a large US study of more than 5,000 people and their children found that giving the polypill to everyone over 60 would save the most lives, preventing more than 100 heart attacks per 1,000 people.
However, to be economic in the over-60s, it would need to cost less than £282 a year.
Even if the pill was free, researchers said it would not be worth giving it to people at moderate cardiovascular risk.
J Epidem Comm Health, 2006; 60: 213-7.