Polypill (fixed-dose combinations) in the prevention of cardiovascular disease: rationale and clinical data

Author(s): Kavita Singh, Abdul Salam, Raji Devarajan, Anushka Patel4, Dorairaj Prabhakaran

Cardiovascular diseases (CVDs) continue to be major contributors of death and disability globally. Control of CVD risk factors has been shown to be effective in reducing morbidity and mortality both in primary and secondary prevention settings. Given the cumulative benefits of concurrently controlling multiple CVD risk factors (high blood pressure, dyslipidemia and platelet activity) in individuals at high risk, administration of a polypill consisting of antihypertensive, antidyslipidemic and antiplatelet agents together could simultaneously lower multiple risk factors and applying such a population risk-reduction strategy has the potential to considerably reduce CVD burden. Furthermore, the availability of an inexpensive generic polypill might improve medication adherence and reduce the evidence–practice gap for individuals who already have an indication for long-term treatment with these agents. A few clinical trials have provided early evidence about the safety and efficacy of polypill in primary prevention, however, the result of studies with hard clinical outcomes is some years away.