Finding new strategies for prevention of cardiovascular disease (CVD) is the subject of constant research. One of these new approaches involves wider use of proven, inexpensive and safe pharmacological therapies, provided by a “polypill”. It has been suggested that the polypill, a fixed-dose combination drug, administered once daily, could intervene simultaneously on several common risk factors and theoretically reduce CVD to a large extent. Since >90% of CVD deaths occur in individuals aged ≥55 years, the investigators suggest that this polypill should be used in this age category, especially for those with at least 1 additional risk factor for primary prevention. The authors also suggest that the use of the polypill may lead to more widespread and cost-effective secondary prevention. The potential advantages of the polypill are improving delivery of care, improving adherence, reducing cost and possibly reaching a much wider number of at-risk individuals. However, many studies will be required to address several issues such as the lack of evidence that a polypill will reduce CVD events and is safe in middle-aged individuals in primary prevention; the pharmaceutical formulation involving 4 or 5 active components; the composition of the polypill to have the best efficacy; the adherence; the cost-effectiveness; and the interference with lifestyle. The authors also point out that polypill should not be considered in isolation but as an integral part of a comprehensive CVD prevention strategy that includes quitting smoking, increasing physical activity and consuming a healthy diet.
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