Abstract

Recent evidence of cardiovascular disease prevention by polypills: A mini review

Author(s): Antonio Coca, Jose Patricio Lopez-Lopez

Despite explicit guideline recommendations for the diagnosis and management of Cardiovascular Risk Factors (CVRF) such as hypertension, dyslipidaemia, obesity, and hyperglycaemia, a large proportion of patients remain undiagnosed, untreated, or treated but uncontrolled. Inadequate control of CVRF is associated with many complex factors including physician’s inertia, health systems disparities, and poor adherence to prescribed antihypertensive drug treatment by patients. This problem has been seen not only in the primary prevention of patients with different CVRF but also in the secondary prevention of recurrent Cardiovascular (CV) events in patients with atherosclerotic CV disease such as Coronary Artery Disease (CAD) or stroke. All guidelines recommend treatment with at least a Renin‐Angiotensin‐Aldosterone System (RAS) blocker (Angiotensin‐Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB), statin, and antiagregant. To improve adherence with this multiple drug therapy the preferred use of a single pill combination, the polypill, is recommended in most guidelines. This strategy is supported by robust evidence demonstrating better adherence and long-term persistence on treatment, with the consequent reduction of CV events and CV mortality in primary or secondary CV disease prevention. This review summarizes the latest evidence supporting these recommendations.