TY - JOUR
T1 - Role of the polypill for secondary prevention in ischaemic heart disease
AU - Castellano, José M
AU - Fuster, Valentín
AU - Jennings, Catriona
AU - Prescott, Eva
AU - Bueno, Héctor
PY - 2017/6
Y1 - 2017/6
N2 - In 2011, for the first time in the history of humankind, non-communicable diseases became the leading cause of death worldwide. This change in trend is obviously multifactorial and very complex, as it is the paradoxical result of social, economic and health system growth worldwide. Vaccination and infectious diseases control, changing dietary habits worldwide, sedentary behaviour, globalisation, industrialisation (resulting in a shift from manual to sedentary labour), tobacco and sugary beverage surges in low- and middle-income countries and rapid urbanisation have all played a role in this epidemic transition. At the same time, the increase in cardiovascular risk factors, together with a decline in mortality in high-income countries in the past two decades, has led to a significant upsurge in the prevalence of secondary prevention of ischaemic heart disease. With this, the effect that non-adherence to cardioprotective drugs is having has become progressively clear, both in terms of clinical outcomes and as a driver of increased healthcare expenditure. The cardiovascular polypill, which was originally proposed as a strategy to improve accessibility to cardioprotective drugs worldwide, has proven to be a mainstay therapeutic approach for improving medication adherence in cardiovascular disease. In the current paper, we aim to review the need for a polypill strategy in the present scenario of cardiovascular disease, the available data that support such a strategy and the various clinical trials that are in progress that will help further shape future indications for the cardiovascular polypill.
AB - In 2011, for the first time in the history of humankind, non-communicable diseases became the leading cause of death worldwide. This change in trend is obviously multifactorial and very complex, as it is the paradoxical result of social, economic and health system growth worldwide. Vaccination and infectious diseases control, changing dietary habits worldwide, sedentary behaviour, globalisation, industrialisation (resulting in a shift from manual to sedentary labour), tobacco and sugary beverage surges in low- and middle-income countries and rapid urbanisation have all played a role in this epidemic transition. At the same time, the increase in cardiovascular risk factors, together with a decline in mortality in high-income countries in the past two decades, has led to a significant upsurge in the prevalence of secondary prevention of ischaemic heart disease. With this, the effect that non-adherence to cardioprotective drugs is having has become progressively clear, both in terms of clinical outcomes and as a driver of increased healthcare expenditure. The cardiovascular polypill, which was originally proposed as a strategy to improve accessibility to cardioprotective drugs worldwide, has proven to be a mainstay therapeutic approach for improving medication adherence in cardiovascular disease. In the current paper, we aim to review the need for a polypill strategy in the present scenario of cardiovascular disease, the available data that support such a strategy and the various clinical trials that are in progress that will help further shape future indications for the cardiovascular polypill.
KW - Administration, Oral
KW - Cardiovascular Agents/administration & dosage
KW - Cost-Benefit Analysis
KW - Disease Progression
KW - Drug Combinations
KW - Drug Costs
KW - Humans
KW - Medication Adherence
KW - Myocardial Ischemia/drug therapy
KW - Recurrence
KW - Risk Factors
KW - Secondary Prevention/economics
KW - Tablets
KW - Treatment Outcome
U2 - 10.1177/2047487317707324
DO - 10.1177/2047487317707324
M3 - Journal article
C2 - 28618914
SN - 2047-4873
VL - 24
SP - 44
EP - 51
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 3_suppl
ER -
