The effects of fixed-dose combination therapy on all-cause mortality or ASCVD events are uncertain .
A limited number of trials reported these outcomes , and the included trials were primarily design ed to observe changes in ASCVD risk factor levels rather than clinical events , which may partially explain the observed differences in risk factors that were not translated into differences in clinical outcomes among the included trials .
Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo , active comparator , or usual care but may be associated with improved adherence to a multidrug regimen .
Ongoing , longer-term trials of fixed-dose combination therapy will help demonstrate whether short-term changes in risk factors might be maintained and lead to expected differences in clinical events based on these changes
BACKGROUND Atherosclerotic cardiovascular disease ( ASCVD ) is the leading cause of death and disability worldwide , yet ASCVD 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 ASCVD .
OBJECTIVES To determine the effect of fixed-dose combination therapy on all-cause mortality , fatal and non-fatal ASCVD events , and adverse events .
We also sought to determine the effect of fixed-dose combination therapy on blood pressure , lipids , adherence , discontinuation rates , health-related quality of life , and costs .
Polypill-based therapy likely to reduce ethnic inequities in use of cardiovascular preventive medications: Findings from a pragmatic randomised controlled trial
Objective The purpose of this study was to investigate the consistency of the proportional effect of fixed-dose combination therapy ( the ‘ polypill ’ ) on the use of recommended cardiovascular preventative medications among indigenous Māori and non-indigenous adults in New Zeal and . Methods We r and omised Māori and non-Māori primary care patients at high risk of cardiovascular disease ( either because of a prior event or with an estimated 5-year risk of a first event of at least 15 % ) to a polypill ( containing aspirin , statin and two antihypertensives ) or usual care for a minimum of 12 months . All patients had indications for all polypill components according to their general practitioner , and all medications ( including the polypill )  were prescribed by the patient ’s general practitioner and dispensed at community pharmacies . The main outcome for this study was the use of all recommended medications ( antiplatelet , statin and two antihypertensives ) at 12 months . Heterogeneity in the effect of polypill-based care compared with usual care on this outcome by ethnicity was assessed by logistic regression . Results Baseline use of recommended medications was 36 % ( 93/257 ) among Māori and 51 % ( 130/156 ) among non-Māori participants .  Polypill-based care was associated with an increase in the use of recommended medications among Māori ( relative risk [ RR ] : 1.87 ; 95 % confidence interval [ CI ] : 1.50–2.34 ) and non-Māori ( RR : 1.66 ; 95 % CI : 1.37–2.00 ) when compared with usual care at 12 months , and there was no statistically significant heterogeneity in this outcome by ethnicity ( p = 0.92 ) . Conclusion Polypill-based care is likely to reduce absolute inequities between Māori and non-Māori in the use of recommended cardiovascular preventative medications given baseline absolute differences and the consistency of the proportional effect of this intervention by ethnicity in this pragmatic trial in primary care
The effects of fixed-dose combination therapy on all-cause mortality or ASCVD events are uncertain .
A limited number of trials reported these outcomes , and the included trials were primarily design ed to observe changes in ASCVD risk factor levels rather than clinical events , which may partially explain the observed differences in risk factors that were not translated into differences in clinical outcomes among the included trials .
Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo , active comparator , or usual care but may be associated with improved adherence to a multidrug regimen .
Ongoing , longer-term trials of fixed-dose combination therapy will help demonstrate whether short-term changes in risk factors might be maintained and lead to expected differences in clinical events based on these changes
BACKGROUND Atherosclerotic cardiovascular disease ( ASCVD ) is the leading cause of death and disability worldwide , yet ASCVD 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 ASCVD .
OBJECTIVES To determine the effect of fixed-dose combination therapy on all-cause mortality , fatal and non-fatal ASCVD events , and adverse events .
We also sought to determine the effect of fixed-dose combination therapy on blood pressure , lipids , adherence , discontinuation rates , health-related quality of life , and costs .