Frontiers of cardiovascular polypills: From atherosclerosis and beyond

Trends Cardiovasc Med. 2023 Apr;33(3):182-189. doi: 10.1016/j.tcm.2021.12.013. Epub 2021 Dec 30.

Abstract

Fixed-dose combination (FDC) therapies (also known as polypills) remain underutilized in clinical practice despite over two decades of evidence from randomized controlled trials demonstrating increased adherence to multidrug therapy, improved cardiovascular disease (CVD) risk factor control, and lower incidence of cardiovascular events. Evidence demonstrates that FDC-based implementation strategies can substantially complement and augment current strategies for CVD risk prevention globally. The next decade is likely to extend the frontier of cardiovascular FDC therapies, particularly given expected advances in FDC manufacturing technology and accessibility. FDC-based anti-hypertensive therapies are emerging as integral components of a pragmatic blood pressure lowering strategy. Cardiovascular FDCs are rapidly approaching its coming of age, transforming from heavily hyped research tools to pragmatic clinical instruments. This review evaluates the current evidence for cardiovascular FDCs, barriers to current use, and potential next generation advances.

Keywords: Atherosclerosis; Cardiovascular disease; Fixed dose combination; Hypertension; Polypill; Prevention.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / adverse effects
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / drug therapy
  • Atherosclerosis* / epidemiology
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / drug therapy
  • Cardiovascular Diseases* / epidemiology
  • Drug Combinations
  • Drug Therapy, Combination
  • Humans
  • Leprostatic Agents / therapeutic use
  • Platelet Aggregation Inhibitors / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Drug Combinations
  • Leprostatic Agents
  • Antihypertensive Agents