Reductions in blood pressure and lipid parameters are generally lower than those previously projected , though substantial heterogeneity of results exists .
Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo , single drug active component , or usual care but may be associated with improved adherence to a multidrug regimen .
BACKGROUND Cardiovascular disease ( CVD ) is the leading cause of death and disability worldwide , yet CVD risk factor control and secondary prevention rates remain low .
A fixed-dose combination of blood pressure and cholesterol lowering and antiplatelet treatments into a single pill , or polypill , has been proposed as one strategy to reduce the global burden of CVD by up to 80 % given its potential for better adherence and lower costs .
OBJECTIVES To determine the effectiveness of fixed-dose combination therapy on reducing fatal and non-fatal CVD events and on improving blood pressure and lipid CVD risk factors for both primary and secondary prevention of CVD .
We also aim ed to determine discontinuation rates , adverse events , health-related quality of life , and costs of fixed-dose combination therapy .
Implementation of a simple age-based strategy in the prevention of cardiovascular disease: the Polypill approach.
BACKGROUND A combination of medications that simultaneously reduce several cardiovascular risk factors in people above a specified age , without selection based on risk factor measurement , has been proposed as a simple strategy for reducing the risk of cardiovascular disease and shown to be effective in r and omized trials ( the Polypill approach ) . AIMS To assess acceptance of the Polypill approach and adherence to preventive treatment among individuals taking part in a cardiovascular disease prevention service . METHODS Daily treatment with simvastatin ( 40 mg ) , amlodipine ( 2.5 mg ) , bendroflumethiazide ( 1.25 mg ) , lisinopril ( 5 mg ) [ or c and esartan ( 4 mg ) if cough was reported ] and folic acid ( 0.8 mg ) was offered , as separate components , to people ≥ 55 years with no history of cardiovascular , renal or liver disease . An audit of adverse effects , adherence and requests for blood pressure and cholesterol measurement was determined by telephone consultation . RESULTS Between 2006 and 2010 , 269 participants started treatment with the Polypill components . Follow-up ranged from 3 to 48 months ( mean 20 ) . A total of 222 participants ( 83 % ) adhered to treatment , including 30 ( 11 % ) who switched from the angiotensin-converting enzyme inhibitor ( lisinopril ) to the angiotensin receptor blocker ( c and esartan ) because of cough . Ten participants ( 4 % ) continued to take treatment but stopped taking one or more drugs because of other symptoms , and 37 ( 14 % ) stopped all treatment , eight because of adverse effects and 29 for non-medical reasons . No one requested a blood pressure or cholesterol measurement . CONCLUSION This is the first demonstration of the application of the Polypill approach in practice . The method was accepted and the Polypill components were well tolerated , with good adherence and no dem and for information about risk factors
Reductions in blood pressure and lipid parameters are generally lower than those previously projected , though substantial heterogeneity of results exists .
Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo , single drug active component , or usual care but may be associated with improved adherence to a multidrug regimen .
BACKGROUND Cardiovascular disease ( CVD ) is the leading cause of death and disability worldwide , yet CVD risk factor control and secondary prevention rates remain low .
A fixed-dose combination of blood pressure and cholesterol lowering and antiplatelet treatments into a single pill , or polypill , has been proposed as one strategy to reduce the global burden of CVD by up to 80 % given its potential for better adherence and lower costs .
OBJECTIVES To determine the effectiveness of fixed-dose combination therapy on reducing fatal and non-fatal CVD events and on improving blood pressure and lipid CVD risk factors for both primary and secondary prevention of CVD .
We also aim ed to determine discontinuation rates , adverse events , health-related quality of life , and costs of fixed-dose combination therapy .