Redefining the polypill: pros and cons in cardiovascular precision medicine
- PMID: 37799963
- PMCID: PMC10549989
- DOI: 10.3389/fphar.2023.1268119
Redefining the polypill: pros and cons in cardiovascular precision medicine
Abstract
Polypill is a multi-drug formulation in a single pill intended to simplify the drug regimen and reduce medication-induced adverse effects. The most common multidrug combinations in a polypill are used to treat cardiovascular diseases and are targeted against key modifiable risk factors such as hypertension and hyperlipidemia. These contain blood-pressure lowering agents, statins, and anti-platelet agents usually in a fixed dose. Polypills can be an affordable therapeutic intervention for treating high-risk patients, as these are proven to increase patients' adherence to medication and improve clinical outcomes. Over the previous years, randomized clinical trials of several polypills have yielded contradictory findings, raising skepticism regarding their widespread use in primary disease prevention. Here, we have reviewed the concept of polypills, the evidence-based strengths, the limitations of this polypharmacy intervention strategy, and discussed future directions for their use in the primary and secondary preventive management of cardiovascular diseases and associated risk factors.
Keywords: CVD; LDL; NAFLD; genomics; hypertension; multi-drug; polypill; precision medicine.
Copyright © 2023 Birla, Angural, Madathumchalil, Shende, Shastry, Mahadevappa, Shambhu, Vishwanath and Prashant.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Similar articles
-
Impact of switching from different treatment regimens to a fixed-dose combination pill (polypill) in patients with cardiovascular disease or similarly high risk.Eur J Prev Cardiol. 2017 Jun;24(9):951-961. doi: 10.1177/2047487317695616. Epub 2017 Mar 8. Eur J Prev Cardiol. 2017. PMID: 28436727 Clinical Trial.
-
The feasibility of polypill for cardiovascular disease prevention in Asian Population.J Clin Hypertens (Greenwich). 2021 Mar;23(3):545-555. doi: 10.1111/jch.14075. Epub 2020 Oct 21. J Clin Hypertens (Greenwich). 2021. PMID: 33086429 Free PMC article. Review.
-
A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk.Eur J Prev Cardiol. 2015 Jul;22(7):920-30. doi: 10.1177/2047487314530382. Epub 2014 Mar 27. Eur J Prev Cardiol. 2015. PMID: 24676715 Clinical Trial.
-
The Impact of Polypill on Adherence and Cardiovascular Outcomes: A Comprehensive Systematic Review with Meta-Analysis.Curr Cardiol Rev. 2024;20(2):61-71. doi: 10.2174/011573403X283174240110025442. Curr Cardiol Rev. 2024. PMID: 38265377 Free PMC article.
-
Strengths and Limitations of Using the Polypill in Cardiovascular Prevention.Curr Cardiol Rep. 2017 May;19(5):45. doi: 10.1007/s11886-017-0853-y. Curr Cardiol Rep. 2017. PMID: 28425033 Free PMC article. Review.
Cited by
-
Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management.J Clin Med. 2023 Nov 22;12(23):7226. doi: 10.3390/jcm12237226. J Clin Med. 2023. PMID: 38068278 Free PMC article. Review.
-
The CNIC-polypill (acetylsalicylic acid, atorvastatin, and ramipril), an effective and cost-saving secondary prevention strategy compared with other therapeutic options in patients with ischaemic heart disease.Eur Heart J Open. 2024 Apr 2;4(2):oeae027. doi: 10.1093/ehjopen/oeae027. eCollection 2024 Mar. Eur Heart J Open. 2024. PMID: 38686352 Free PMC article.
-
Polypill Strategy: A Paradigm Shift in Cardiovascular Disease Prevention.Am J Cardiovasc Drugs. 2025 Aug 13. doi: 10.1007/s40256-025-00758-5. Online ahead of print. Am J Cardiovasc Drugs. 2025. PMID: 40802150 No abstract available.
References
-
- Aguiar C., Araujo F., Rubio-Mercade G., Carcedo D., Paz S., Castellano J. M., et al. (2022). Cost-effectiveness of the CNIC-polypill strategy compared with separate monocomponents in secondary prevention of cardiovascular and cerebrovascular disease in Portugal: The MERCURY study. J. Health Econ. Outcomes Res. 9 (2), 134–146. 10.36469/001c.39768 - DOI - PMC - PubMed
-
- Becerra V., Gracia A., Desai K., Abogunrin S., Brand S., Chapman R., et al. (2015). Cost-effectiveness and public health benefit of secondary cardiovascular disease prevention from improved adherence using a polypill in the UK. BMJ Open 5 (5), e007111. 10.1136/bmjopen-2014-007111 - DOI - PMC - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Miscellaneous