For Prevention of Cardiovascular disease
The World Health Organization (WHO) had proposed the cardiovascular polypill more than a decade ago as a ‘best buy’ intervention for secondary prevention, and a simple, cost-effective strategy to reduce the evidence implementation gap and as an instrument to improve the prescription, accessibility, adherence and cost of secondary CVD prevention.
The concept of a polypill, composed of a combination of medications that are known to effectively treat CVD, has been proposed as a simple, cost effective and innovative public health strategy to combat the CVD epidemic on a global scale. Several studies have shown the polypill to be well tolerated and superior in terms of adherence to standard of care.
Polypills include guideline-recommended treatments for secondary prevention, such as BP-lowering, cholesterol-lowering and antiplatelet drugs. Polypill strategies have been shown to be effective.
Safe and cost-effective in terms of increasing drug adherence and improving risk factor profiles. As a result of these findings, the use of polypills was included in the 2016 European Guidelines on CVD prevention in clinical practice.
A cardiovascular Polypill could be one potential solution to poor compliance by simplifying the treatment regimen.
The POLYCAP is fixed-dose combination of three blood-pressure-lowering drugs, Atenolol 50 mg, Ramipril 5 mg, Hydrochlorothiazide 12.5 mg, along with a lipid lowering drug, Simvastatin 20mg and an anti-platelet agent, Aspirin 100mg.
View More Polypill in GuidelinesGuidelines for the management of arterial hypertension 2013 ESH/ESC guidelines.
- TIPS study has shown that, when combined into the Polypill, different agents maintain all or most their expected effects.
- The treatment simplification associated with this approach may only be considered, if the need for each Polypill component has been previously established.
European Guidelines on cardiovascular disease prevention in clinical practice 2012 guidelines:
- Reducing dosage demands in persons at high CVD risk may result in the prescription of combination pharmacotherapy, the ‘Polypill’.
- Recently, a randomized phase II trial in middle-aged individuals without CVD demonstrated that the ‘Polycap’ formulation could conveniently reduce multiple risk factors.
WHO Expert committee recommendation:
- Fixed dose combination therapy including aspirin, beta-blockers, ACE-inhibitors, and statins have been advocated by the WHO for CVD.
Recommendation from ELITE organizations:
- Reducing dosage demands is the most effective single approach toward enhancing adherence.
- Fixed dose combination therapy (POLYCAP) reduces dosage demands.
Polypill in Textbook :
Harrison's Principles of Internal Medicine 17th edition Chapter: e38, THE POLYPILL.
- The concept of a Polypill to reduce the burden of CVD is attractive and seems to have great potential, especially in secondary and high-risk primary prevention.
- Polypill would be applicable to the wider population, with greater safety.
