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One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease
Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high w...
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Published in: | The American journal of cardiology 2023-09, Vol.203, p.493-495 |
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description | Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care. Nonadherence to medication therapy is common and associated with poor outcomes in the population receiving secondary prevention.2 By simplifying medication regimens, the polypill strategy significantly improves patient adherence to prescribed therapies.3 In the prevention or treatment of CVD, the polypill strategy reduces surrogate end points such as blood pressure and low-density lipid low-density lipoprotein-cholesterol levels.4 More importantly, large clinical trials have shown that polypills reduce clinical outcomes such as a composite of major adverse cardiovascular events. Dihydropyridine calcium channel blockers also reduce blood pressure to a greater extent in Eastern Asians.13 In the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial, cardiovascular outcomes were greater in Black participants randomized to ACE inhibitors than among those receiving a calcium channel blocker or thiazide diuretic.14 Therefore, healthcare providers should consider ethnic and racial differences when prescribing polypills in a diverse population. |
doi_str_mv | 10.1016/j.amjcard.2023.06.106 |
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Twenty Years of Polypill for Cardiovascular Disease</title><source>ScienceDirect Journals</source><creator>Tran, Rebecca J.C.</creator><creatorcontrib>Tran, Rebecca J.C.</creatorcontrib><description>Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care. Nonadherence to medication therapy is common and associated with poor outcomes in the population receiving secondary prevention.2 By simplifying medication regimens, the polypill strategy significantly improves patient adherence to prescribed therapies.3 In the prevention or treatment of CVD, the polypill strategy reduces surrogate end points such as blood pressure and low-density lipid low-density lipoprotein-cholesterol levels.4 More importantly, large clinical trials have shown that polypills reduce clinical outcomes such as a composite of major adverse cardiovascular events. Dihydropyridine calcium channel blockers also reduce blood pressure to a greater extent in Eastern Asians.13 In the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial, cardiovascular outcomes were greater in Black participants randomized to ACE inhibitors than among those receiving a calcium channel blocker or thiazide diuretic.14 Therefore, healthcare providers should consider ethnic and racial differences when prescribing polypills in a diverse population.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2023.06.106</identifier><identifier>PMID: 37500317</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Angiotensin ; Angiotensin-converting enzyme inhibitors ; Antihypertensives ; Aspirin ; Blood pressure ; Calcium channel blockers ; Calcium channels ; Cardiovascular disease ; Cardiovascular diseases ; Cholesterol ; Clinical trials ; Density ; Dihydropyridine ; Disease prevention ; Diuretics ; Folic acid ; Health services ; Heart ; Heart diseases ; Ischemia ; Lipids ; Meta-analysis ; Myocardial infarction ; Peptidyl-dipeptidase A ; Population ; Prevention ; Receiving ; Sensitivity analysis ; Statins</subject><ispartof>The American journal of cardiology, 2023-09, Vol.203, p.493-495</ispartof><rights>2023 Elsevier Inc.</rights><rights>2023. 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Twenty Years of Polypill for Cardiovascular Disease</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care. Nonadherence to medication therapy is common and associated with poor outcomes in the population receiving secondary prevention.2 By simplifying medication regimens, the polypill strategy significantly improves patient adherence to prescribed therapies.3 In the prevention or treatment of CVD, the polypill strategy reduces surrogate end points such as blood pressure and low-density lipid low-density lipoprotein-cholesterol levels.4 More importantly, large clinical trials have shown that polypills reduce clinical outcomes such as a composite of major adverse cardiovascular events. Dihydropyridine calcium channel blockers also reduce blood pressure to a greater extent in Eastern Asians.13 In the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial, cardiovascular outcomes were greater in Black participants randomized to ACE inhibitors than among those receiving a calcium channel blocker or thiazide diuretic.14 Therefore, healthcare providers should consider ethnic and racial differences when prescribing polypills in a diverse population.</description><subject>Angiotensin</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Antihypertensives</subject><subject>Aspirin</subject><subject>Blood pressure</subject><subject>Calcium channel blockers</subject><subject>Calcium channels</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>Clinical trials</subject><subject>Density</subject><subject>Dihydropyridine</subject><subject>Disease prevention</subject><subject>Diuretics</subject><subject>Folic acid</subject><subject>Health services</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Ischemia</subject><subject>Lipids</subject><subject>Meta-analysis</subject><subject>Myocardial infarction</subject><subject>Peptidyl-dipeptidase A</subject><subject>Population</subject><subject>Prevention</subject><subject>Receiving</subject><subject>Sensitivity analysis</subject><subject>Statins</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFkD1PwzAQhi0EglL4CaBILCwpvvgjyYRQKV9CokMZmCzXuUiO0rjYTVH_Pa5aGFiYTvfquTv7IeQC6AgoyJtmpBeN0b4aZTRjIypjLA_IAIq8TKEEdkgGlNIsLYGXJ-Q0hCa2AEIekxOWC0oZ5APy8tZhMrVtm9TOJ5M1-o3r8DaZfWG32iQfqH1IXJ1MXbtZ_mDjeNa6tQ6mb7VP7m1AHfCMHNW6DXi-r0Py_jCZjZ_S17fH5_Hda2oYh1Uqcg5czKlktalKIwvIWcFolWHJKROczbmoctAmppKbeVEgrQpj6kJIiAQbkuvd3qV3nz2GlVrYYLBtdYeuDyorBOcM4rcjevUHbVzvu_i6LSVLySjjkRI7yngXgsdaLb1daL9RQNVWtmrUXrbaylZUxljGucv99n6-wOp36sduBG53AEYda4teBWOxM1hZj2alKmf_OfENnjGP5g</recordid><startdate>20230915</startdate><enddate>20230915</enddate><creator>Tran, Rebecca J.C.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9869-8336</orcidid></search><sort><creationdate>20230915</creationdate><title>One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease</title><author>Tran, Rebecca J.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-574145b063fcd9c68173830d2e9403543b45d71ac38364cb88e0d8ccf85614033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Angiotensin</topic><topic>Angiotensin-converting enzyme inhibitors</topic><topic>Antihypertensives</topic><topic>Aspirin</topic><topic>Blood pressure</topic><topic>Calcium channel blockers</topic><topic>Calcium channels</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>Clinical trials</topic><topic>Density</topic><topic>Dihydropyridine</topic><topic>Disease prevention</topic><topic>Diuretics</topic><topic>Folic acid</topic><topic>Health services</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Ischemia</topic><topic>Lipids</topic><topic>Meta-analysis</topic><topic>Myocardial infarction</topic><topic>Peptidyl-dipeptidase A</topic><topic>Population</topic><topic>Prevention</topic><topic>Receiving</topic><topic>Sensitivity analysis</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tran, Rebecca J.C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tran, Rebecca J.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2023-09-15</date><risdate>2023</risdate><volume>203</volume><spage>493</spage><epage>495</epage><pages>493-495</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><notes>SourceType-Other Sources-1</notes><notes>content type line 63</notes><notes>ObjectType-Editorial-2</notes><notes>ObjectType-Commentary-1</notes><abstract>Wald and Law estimated that a combination of a statin, thiazide diuretic, β blocker, angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin could reduce ischemic heart disease events and stroke by 88% and 80%, respectively.1 Because rates of cardiovascular disease (CVD) remain high worldwide, the polypill or fixed dose combination strategy is viewed as a potential method to reduce barriers to adequate medical care. Nonadherence to medication therapy is common and associated with poor outcomes in the population receiving secondary prevention.2 By simplifying medication regimens, the polypill strategy significantly improves patient adherence to prescribed therapies.3 In the prevention or treatment of CVD, the polypill strategy reduces surrogate end points such as blood pressure and low-density lipid low-density lipoprotein-cholesterol levels.4 More importantly, large clinical trials have shown that polypills reduce clinical outcomes such as a composite of major adverse cardiovascular events. Dihydropyridine calcium channel blockers also reduce blood pressure to a greater extent in Eastern Asians.13 In the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial, cardiovascular outcomes were greater in Black participants randomized to ACE inhibitors than among those receiving a calcium channel blocker or thiazide diuretic.14 Therefore, healthcare providers should consider ethnic and racial differences when prescribing polypills in a diverse population.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37500317</pmid><doi>10.1016/j.amjcard.2023.06.106</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0001-9869-8336</orcidid></addata></record> |
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subjects | Angiotensin Angiotensin-converting enzyme inhibitors Antihypertensives Aspirin Blood pressure Calcium channel blockers Calcium channels Cardiovascular disease Cardiovascular diseases Cholesterol Clinical trials Density Dihydropyridine Disease prevention Diuretics Folic acid Health services Heart Heart diseases Ischemia Lipids Meta-analysis Myocardial infarction Peptidyl-dipeptidase A Population Prevention Receiving Sensitivity analysis Statins |
title | One Pill for Everyone? Twenty Years of Polypill for Cardiovascular Disease |
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