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The cardiovascular polypill in high-risk patients.
Eur J Prev Cardiol. 2012 Dec; 19(6):1234-42.EJ

Abstract

Atherosclerotic cardiovascular diseases remain the leading cause of morbidity and mortality in both developed and developing countries. Adequate treatment of vascular risk factors, such as low-density lipoprotein cholesterol and systolic blood pressure are known to reduce the future risk of cardiovascular disease in these patients. However currently, large treatment gaps exist among high-risk individuals, in whom the guidelines recommend concomitant treatment with aspirin, statin, and blood-pressure lowering agents. Combining aspirin, cholesterol, and blood-pressure lowering agents into a single pill called the cardiovascular polypill has been proposed as complementary care in the prevention of cardiovascular diseases in both intermediate- and high-risk patient populations. It is now a decade since the first recommendations to develop and trial cardiovascular polypills. The major scientific debate has been about the appropriate initial target population. This review article focuses on the potential role of fixed-dose combination therapy in different patient populations, outlines the pros and cons of combination therapy, and emphasizes the rationale for trialing their use. Current and planned future cardiovascular polypill trials are summarized and the pre-requisites for implementation of the polypill strategy in both primary and secondary prevention are described. The recent development of combination pills containing off-patent medications holds promise for highly affordable and effective treatment and evidence is emerging on the use of this strategy in high-risk populations.

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Publisher Full Text

Authors+Show Affiliations

Lafeber M
University Medical Center Utrecht, Utrecht, The Netherlands.
Spiering W
No affiliation info available
Singh K
No affiliation info available
Guggilla RK
No affiliation info available
Patil V
No affiliation info available
Webster R
No affiliation info available
SPACE collaboration
No affiliation info available

MeSH

Administration, OralAntihypertensive AgentsAspirinCardiovascular AgentsCardiovascular DiseasesDrug CombinationsHistory, 20th CenturyHistory, 21st CenturyHumansHydroxymethylglutaryl-CoA Reductase InhibitorsPolypharmacyPractice Guidelines as TopicPrimary PreventionRisk AssessmentRisk FactorsSecondary PreventionTabletsTreatment Outcome

Pub Type(s)

Historical Article
Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22019908

Citation

Lafeber, Melvin, et al. "The Cardiovascular Polypill in High-risk Patients." European Journal of Preventive Cardiology, vol. 19, no. 6, 2012, pp. 1234-42.
Lafeber M, Spiering W, Singh K, et al. The cardiovascular polypill in high-risk patients. Eur J Prev Cardiol. 2012;19(6):1234-42.
Lafeber, M., Spiering, W., Singh, K., Guggilla, R. K., Patil, V., & Webster, R. (2012). The cardiovascular polypill in high-risk patients. European Journal of Preventive Cardiology, 19(6), 1234-42. https://doi.org/10.1177/1741826711428066
Lafeber M, et al. The Cardiovascular Polypill in High-risk Patients. Eur J Prev Cardiol. 2012;19(6):1234-42. PubMed PMID: 22019908.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cardiovascular polypill in high-risk patients. AU - Lafeber,Melvin, AU - Spiering,Wilko, AU - Singh,Kavita, AU - Guggilla,Rama K, AU - Patil,Vinodvenkatesh, AU - Webster,Ruth, AU - ,, Y1 - 2011/10/21/ PY - 2011/10/25/entrez PY - 2011/10/25/pubmed PY - 2013/5/3/medline SP - 1234 EP - 42 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 19 IS - 6 N2 - Atherosclerotic cardiovascular diseases remain the leading cause of morbidity and mortality in both developed and developing countries. Adequate treatment of vascular risk factors, such as low-density lipoprotein cholesterol and systolic blood pressure are known to reduce the future risk of cardiovascular disease in these patients. However currently, large treatment gaps exist among high-risk individuals, in whom the guidelines recommend concomitant treatment with aspirin, statin, and blood-pressure lowering agents. Combining aspirin, cholesterol, and blood-pressure lowering agents into a single pill called the cardiovascular polypill has been proposed as complementary care in the prevention of cardiovascular diseases in both intermediate- and high-risk patient populations. It is now a decade since the first recommendations to develop and trial cardiovascular polypills. The major scientific debate has been about the appropriate initial target population. This review article focuses on the potential role of fixed-dose combination therapy in different patient populations, outlines the pros and cons of combination therapy, and emphasizes the rationale for trialing their use. Current and planned future cardiovascular polypill trials are summarized and the pre-requisites for implementation of the polypill strategy in both primary and secondary prevention are described. The recent development of combination pills containing off-patent medications holds promise for highly affordable and effective treatment and evidence is emerging on the use of this strategy in high-risk populations. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/22019908/The_cardiovascular_polypill_in_high_risk_patients_ L2 - https://journals.sagepub.com/doi/10.1177/1741826711428066?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -