Jose M Castellano1, Juan Verdejo2, Salvador Ocampo3, Marco Martinez Rios2, Enrique Gómez-Álvarez4, Gabriela Borrayo5, Emilio Ruiz6, Borja Ibáñez7, Valentin Fuster8. 1. Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Montepríncipe, Grupo HM Hospitales, Madrid, Spain; Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain. 2. Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chavez, Ciudad de México, Mexico. 3. Hospital Angeles Lindavista, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico. 4. Servicio de Cardiología del Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, Mexico. 5. División de la Coordinación de Unidades Médicas de Alta Especialidad, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico. 6. Departamento Médico, Ferrer Internacional, Barcelona, Spain. 7. Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Departamento de Cardiología, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain. 8. Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Institute, the Mount Sinai Medical Center, New York, USA. Electronic address: valentin.fuster@mountsinai.org.
Abstract
BACKGROUND: The cardiovascular disease pandemic has promoted the cardiovascular polypill as one of the most scalable public health strategies to improve cardiovascular risk by increasing accessibility and adherence to treatments. Data from randomized clinical trials has shown that the polypill strategy significantly improves adherence as well as risk factor control (cholesterol and blood pressure), however, to date, no information from phase IV registries has been available. METHODS: We conducted a multicentre, observational and prospective registry of a polypill-based treatment strategy. A total of 1193 patients in Mexico were included. Patient demographics, clinical history, blood pressure, analysis of blood lipids and the Framingham risk score were measured at baseline and after 12 months of treatment with the CNIC-Ferrer polypill. RESULTS: At one year with the polypill, systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels changed from mean 146.9 mmHg to 128 mmHg (p <0.001), and from 89.1 mmHg to 80.4 mmHg (p <0.001) respectively. LDLc levels were significantly reduced 132.5-107.6 mg/dL (p <0.001). The 10 year Framingham cardiovascular disease risk was also reduced in the high-risk group (33.7 + 22.0 vs. 21.2 + 14.8; p <0.001) and in the intermediate risk group (23.7 + 14.8 vs. 12.7 + 11.4; p <0.001). CONCLUSIONS: To our knowledge, the results of the current study constitute the first real life data on the impact of a polypill therapy on cardiovascular risk factor control. The results show major improvements on the primary outcome, above and beyond those presented previously in the setting of randomized clinical trials.
BACKGROUND: The cardiovascular disease pandemic has promoted the cardiovascular polypill as one of the most scalable public health strategies to improve cardiovascular risk by increasing accessibility and adherence to treatments. Data from randomized clinical trials has shown that the polypill strategy significantly improves adherence as well as risk factor control (cholesterol and blood pressure), however, to date, no information from phase IV registries has been available. METHODS: We conducted a multicentre, observational and prospective registry of a polypill-based treatment strategy. A total of 1193 patients in Mexico were included. Patient demographics, clinical history, blood pressure, analysis of blood lipids and the Framingham risk score were measured at baseline and after 12 months of treatment with the CNIC-Ferrer polypill. RESULTS: At one year with the polypill, systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels changed from mean 146.9 mmHg to 128 mmHg (p <0.001), and from 89.1 mmHg to 80.4 mmHg (p <0.001) respectively. LDLc levels were significantly reduced 132.5-107.6 mg/dL (p <0.001). The 10 year Framingham cardiovascular disease risk was also reduced in the high-risk group (33.7 + 22.0 vs. 21.2 + 14.8; p <0.001) and in the intermediate risk group (23.7 + 14.8 vs. 12.7 + 11.4; p <0.001). CONCLUSIONS: To our knowledge, the results of the current study constitute the first real life data on the impact of a polypill therapy on cardiovascular risk factor control. The results show major improvements on the primary outcome, above and beyond those presented previously in the setting of randomized clinical trials.
Authors: Jens Lehmann; David Riedl; Monika Sztankay; Christian Boehme; Julian Fischnaller; Stefan Kiechl; Bernhard Holzner; Michael Knoflach; Gerhard Rumpold Journal: Eur J Neurol Date: 2021-09-09 Impact factor: 6.288
Authors: Enrique Gómez-Álvarez; Juan Verdejo; Salvador Ocampo; Carlos I Ponte-Negretti; Emilio Ruíz; Marco Martínez Ríos Journal: Int J Cardiol Heart Vasc Date: 2020-06-03