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Polypill Strategy Promising in Socioeconomically Vulnerable

Reductions in systolic blood pressure, LDL cholesterol levels greater with polypill in minority population

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WEDNESDAY, Sept. 18, 2019 (HealthDay News) -- In a socioeconomically vulnerable minority population, a combination pill (polypill) leads to greater reductions in systolic blood pressure and low-density lipoprotein (LDL) cholesterol levels, according to a study published in the Sept. 19 issue of the New England Journal of Medicine.

Daniel Muñoz, M.D., from the Vanderbilt Translational and Clinical Cardiovascular Research Center in Nashville, Tennessee, and colleagues conducted a randomized trial involving 303 adults (96 percent black; three-quarters with an annual income <$15,000) without cardiovascular disease. Participants were randomly assigned to either the polypill (monthly cost, $26), which included atorvastatin, amlodipine, losartan, and hydrochlorothiazide, or usual care.

Adherence to the polypill regimen was 86 percent at 12 months, as assessed on the basis of pill counts. The researchers observed a decrease in mean systolic blood pressure of 9 mm Hg in the polypill group versus 2 mm Hg in the usual-care group (difference, −7 mm Hg). In the polypill and usual-care groups, mean low-density lipoprotein cholesterol levels decreased by 15 and 4 mg/dL, respectively (difference, −11 mg/dL).

"Although the precision approach has clear virtues, a broader approach may benefit patients who face barriers to accessing the full advantages of precision medicine," the authors write. "The simplicity and low cost of the polypill regimen make this approach attractive when such barriers are common."

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