Reaching cardiovascular prevention guideline targets with a polypill-based approach: a meta-analysis of randomised clinical trials

Abstract

Polypill-based therapy significantly improved the achievement of all three ESC targets for BP, LDL and antiplatelet therapy compared with usual care, particularly among those undertreated at baseline.

Promises, promises, and precision medicine

“…Trials of pharmacogenomic dosing of warfarin, in which "precise" dosing is needed to balance the antithrombotic effect of the drug against the risk of severe bleeding, have shown no benefit of such testing (9). By contrast, trials of a one-size-fits-all pill containing aspirin, a statin, and an antihypertensive -the very antithesis of precision medicine -for the prevention of cardiovascular disease have shown effectiveness (10).…”

Polypill strategy at the heart of cardiovascular secondary prevention

“…In their  Heart  paper, Selak and colleagues10 present an individual participant data meta-analysis of three randomised clinical trials comparing a polypill strategy (containing aspirin, a statin and an antihypertensive drug) with standard care. The main goal of the analysis was to determine the proportion of patients in the polypill and usual care arms meeting 2016 ESC prevention guideline2 targets for LDL cholesterol, blood pressure and antiplatelet use.…”

How ACE inhibitors transformed the renin–angiotensin system

“…Prophylactic use of ACE inhibitors is already known to be effective in cardiovascular disease, as a component of the polypill, a fixed dose combination of aspirin, a statin and an anti‐hypertensive agent. Most recently, three reports have shown polypill treatment, for 12 months or 5 years, to reduce the incidence and risk of cardiovascular events in patient populations lacking access to adequate medical care (Muñoz et al, 2019; Roshandel et al, 2019; Selak et al, 2019).…”