A Polypill Strategy to Improve Global Secondary Cardiovascular Prevention From Concept to Reality

被引:57
作者
Castellano, Jose M. [1 ,2 ]
Sanz, Gines [2 ]
Ortiz, Antonio Fernandez [2 ]
Garrido, Ester [3 ,4 ]
Bansilal, Sameer [1 ]
Fuster, Valentin [1 ,2 ]
机构
[1] Mt Sinai Med Ctr, Cardiovasc Inst, New York, NY 10029 USA
[2] CNIC, Madrid, Spain
[3] Grad Sch Biomed Sci Mt Sinai, New York, NY USA
[4] Ferrer Int, Barcelona, Spain
关键词
cardiovascular disease; fixed-dose combination; global cardiovascular health; polypill; secondary prevention; HIGH-RISK; COST-EFFECTIVENESS; INCOME COUNTRIES; CONTROLLED-TRIAL; HEART-DISEASE; MIDDLE-INCOME; ADHERENCE; HEALTH; DRUG; INTERVENTIONS;
D O I
10.1016/j.jacc.2014.06.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The prevention of cardiovascular disease (CVD) by using a polypill has gained increasing momentum as a strategy to contain progression of the disease. Since its initial conception just over a decade ago, only a handful of trials have been completed assessing the efficacy and safety of this innovative concept. The results of these trials have supported the viability of the polypill in CVD prevention and management, albeit with a few caveats, essentially related to the lack of evidence on the effect of the polypill to effectively reduce cardiovascular events. The polypill has the potential to control the global health epidemic of CVD by effectively reaching underdeveloped regions of the world, simplifying healthcare delivery, improving cost-effectiveness, increasing medication adherence, and supporting a comprehensive prescription of evidence-based cardioprotective drugs. Major trials underway will provide definitive evidence on the efficacy of the polypill in reducing cardiovascular events in a cost-effective manner. The results of these studies will determine whether a polypill strategy can quell the burgeoning public health challenge of CVD and will potentially provide the evidence to implement an effective, simple, and innovative solution to restrain the global CVD pandemic. (C) 2014 by the American College of Cardiology Foundation.
引用
收藏
页码:613 / 621
页数:9
相关论文
共 41 条
[1]  
Alwan A, 2011, GLOBAL STATUS REPORT ON NONCOMMUNICABLE DISEASES 2010, pVII
[2]  
[Anonymous], EUR J PREV CARDIOL
[3]  
[Anonymous], 2011, WHO I Global atlas on cardiovascular disease prevention and control
[4]  
[Anonymous], 2012 NHLBI FACT BOOK
[5]  
[Anonymous], PREV CARD DIS MIDDL
[6]  
[Anonymous], HEART OUTC PREV EV 3
[7]  
[Anonymous], HEART OUTC PREV EV 4
[8]   Global public health: a scorecard [J].
Beaglehole, Robert ;
Bonita, Ruth .
LANCET, 2008, 372 (9654) :1988-1996
[9]   The Impact of Medication Adherence on Coronary Artery Disease Costs and Outcomes: A Systematic Review [J].
Bitton, Asaf ;
Choudhry, Niteesh K. ;
Matlin, Olga S. ;
Swanton, Kellie ;
Shrank, William H. .
AMERICAN JOURNAL OF MEDICINE, 2013, 126 (04) :357.e7-357.e27
[10]   Aiming at Strategies for a Complex Problem of Medical Nonadherence [J].
Castellano, Jose M. ;
Copeland-Halperin, Robert ;
Fuster, Valentin .
GLOBAL HEART, 2013, 8 (03) :263-271