Martin, S. S. et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation 149, e347–e913 (2024).
GBD 2016 Causes of Death Collaborators. Global, regional, and national age–sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390, 1151–1210 (2017).
Google Scholar
Roth, G. A. et al. Global, regional, and national age–sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1736–1788 (2018).
Google Scholar
Kyu, H. H. et al. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1859–1922 (2018).
Google Scholar
Roth, G. A. et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J. Am. Coll. Cardiol. 70, 1–25 (2017).
Google Scholar
Yusuf, S. et al. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 378, 1231–1243 (2011).
Google Scholar
Wilkins, E. et al. European Cardiovascular Disease Statistics 2017 (European Heart Network, 2017).
Castellano, J. M. et al. A polypill strategy to improve adherence: results from the FOCUS project. J. Am. Coll. Cardiol. 64, 2071–2082 (2014).
Google Scholar
Chowdhury, R. et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur. Heart J. 34, 2940–2948 (2013).
Google Scholar
Castellano, J. M., Copeland-Halperin, R. & Fuster, V. Aiming at strategies for a complex problem of medical nonadherence. Glob. Heart 8, 263–271 (2013).
Google Scholar
Ho, P. M., Bryson, C. L. & Rumsfeld, J. S. Medication adherence: its importance in cardiovascular outcomes. Circulation 119, 3028–3035 (2009).
Google Scholar
Bansilal, S. et al. Assessing the impact of medication adherence on long-term cardiovascular outcomes. J. Am. Coll. Cardiol. 68, 789–801 (2016).
Google Scholar
Thom, S. et al. Effects of a fixed-dose combination strategy on adherence and risk factors in patients with or at high risk of CVD: the UMPIRE randomized clinical trial. JAMA 310, 918–929 (2013).
Google Scholar
Patel, A. et al. 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. 22, 920–930 (2014).
Google Scholar
Selak, V. et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ 348, g3318 (2014).
Google Scholar
Webster, R. et al. Effectiveness of fixed dose combination medication (‘polypills’) compared with usual care in patients with cardiovascular disease or at high risk: a prospective, individual patient data meta-analysis of 3140 patients in six countries. Int. J. Cardiol. 205, 147–156 (2016).
Google Scholar
Castellano, J. M., Sanz, G. & Fuster, V. Evolution of the polypill concept and ongoing clinical trials. Can. J. Cardiol. 30, 520–526 (2014).
Google Scholar
Castellano, J. M. et al. Polypill strategy in secondary cardiovascular prevention. N. Engl. J. Med. 387, 967–977 (2022). Results of the first prospective randomized clinical trial to test the efficacy of a polypill in secondary prevention. Patients randomized to a polypill showed a 24% relative risk reduction in the primary outcome compared to those who received standard of care.
Google Scholar
González-Juanatey, J. R. et al. The CNIC-Polypill reduces recurrent major cardiovascular events in real-life secondary prevention patients in Spain: the NEPTUNO study. Int. J. Cardiol. 361, 116–123 (2022). Using retrospective data, this study shows the clinical performance of the polypill in a real-life setting in a secondary prevention Spanish population who were treated for 2 years with polypill versus same components versus equipotent components versus other. The polypill showed a 21-27% relative risk reduction compared to other groups.
Google Scholar
Agarwal, A. et al. Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular disease. Nat. Med. 30, 1199–1209 (2024). An important review that presents clinical evidence for the use of the polypill both in primary and secondary prevention.
Google Scholar
Barrios, V. et al. Usefulness of a cardiovascular polypill in the treatment of secondary prevention patients in Spain: a cost-effectiveness study. Rev. Esp. Cardiol. (Engl. Ed.) 70, 42–49 (2017).
Google Scholar
Becerra, V. et al. Cost-effectiveness and public health benefit of secondary cardiovascular disease prevention from improved adherence using a polypill in the UK. BMJ Open 5, e007111 (2015).
Google Scholar
Wald, N. J., Luteijn, J. M., Morris, J. K., Taylor, D. & Oppenheimer, P. Cost–benefit analysis of the polypill in the primary prevention of myocardial infarction and stroke. Eur. J. Epidemiol. 31, 415–426 (2016).
Google Scholar
Jahangiri, R. et al. Cost-effectiveness of fixed-dose combination pill (polypill) in primary and secondary prevention of cardiovascular disease: a systematic literature review. PLoS ONE 17, e0271908 (2022).
Google Scholar
Lin, J. K. et al. Cost-effectiveness of a fixed-dose combination pill for secondary prevention of cardiovascular disease in China, India, Mexico, Nigeria, and South Africa: a modelling study. Lancet Glob. Health 7, e1346–e1358 (2019).
Google Scholar
Laba, T. L. et al. An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial. Med. J. Aust. 201, 671–673 (2014).
Google Scholar
Cordero, A. et al. The real-world cost and health resource utilization associated to the CNIC-Polypill compared to usual care. Eur. Heart J. 42, ehab724.2545 (2021).
Google Scholar
Kotseva, K. & EUROASPIRE Investigators. The EUROASPIRE surveys: lessons learned in cardiovascular disease prevention. Cardiovasc. Diagn. Ther. 7, 633–639 (2017).
Google Scholar
Moerschel, K. S. et al. Assessing the probability of risk factor control in patients with coronary heart disease: results from the ESC-EORP EUROASPIRE V survey. Eur. J. Prev. Cardiol. 29, 1465–1475 (2022).
Google Scholar
The CASCADE Collaboration Survival after introduction of HAART in people with known duration of HIV-1 infection. Lancet 355, 1158–1159 (2000).
Google Scholar
Palella, F. J. Jr et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 338, 853–860 (1998).
Google Scholar
Bartsch, S. The global fund to fight AIDS, tuberculosis and malaria. In Global Health Governance and the Fight Against HIV/AIDS 146–171 (Springer, 2007).
Saag, M. S. et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the International Antiviral Society–USA Panel. JAMA 324, 1651–1669 (2020).
Google Scholar
Castellano, J. M., Narula, J., Castillo, J. & Fuster, V. Promoting cardiovascular health worldwide: strategies, challenges, and opportunities. Rev. Esp. Cardiol. (Engl. Ed.) 67, 724–730 (2014).
Google Scholar
Murray, C. J. et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet 386, 2145–2191 (2015).
Google Scholar
Byrne, R. A. et al. 2023 ESC Guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). Eur. Heart J. 44, 3720–3826 (2023).
Google Scholar
Brunström, M. et al. ESH Guidelines for the management of arterial hypertension the Task Force for the management of arterial hypertension of the European Society of Hypertension. Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J. Hypertens. 41, 1874–2071 (2023).
Google Scholar
Huffman, M., Agarwal, A. & Zhu, J. An application to include fixed dose combinations in the WHO Model List of Essential Medicines for primary and secondary prevention of atherosclerotic cardiovascular diseases in adults. This report was presented to WHO and presented all relevant epidemiological, regulatory and clinical evidence to include the cardiovascular polypill as an essential medicine to treat atherosclerotic CVD.
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