Can a polypill one single tablet combat different cardiovascular risk factors?J Am Soc Hypertens. 2018 05; 12(5):335-339.JA
Polypharmacy is defined as the use of two or more drugs simultaneously. Cardiovascular drugs and antihypertensives are commonly prescribed for treatment of cardiovascular disease (CVD), especially in elderly patients. Recent studies in patients with a history of CVD demonstrated that the fixed-dose combination of cardiovascular drugs in a polypill retain their individual efficacy, safety, and tolerability, thus have the potential to improve medication adherence and multiple risk factor control, thereby improving patient outcomes in secondary cardiovascular prevention. Since the initial conception of the fixed-dose polypill, just over a decade ago, only six large randomized trials assessing the efficacy and safety of this innovative concept have been completed (one is still ongoing). The results demonstrate that the polypill therapy significantly improved adherence, lowered systolic blood pressure, and low-density lipoprotein cholesterol, compared with usual care, in patients at high risk for CVD, especially among those who were undertreated at baseline. Correspondingly, further studies showed that the strengths of the polypill include better adherence, equivalent or better risk factor control, and improved quality of life among polypill users, as compared with usual care. However, the long-term outcome of the polypill on CVD events and mortality are unavailable and are currently being studied in clinical trials.