- A combination pill for warding off systolic BP elevation and high low-density lipoprotein cholesterol (LDL-C) beats usual care among socioeconomically vulnerable minorities.
- The intervention proved feasible and effective in this real-world, randomized trial.
Why this matters
- People in vulnerable populations struggle against the dual insult of higher rates of cardiovascular disease and obstacles to preventive care.
- Low-dose polypills show promise for both primary prevention and easier accessibility.
- 96% of trial participants were black, and ~75% had an income
- At baseline, BP was 140/83 mm Hg; LDL-C was 113 mg/dL.
- The polypill cost $26/month.
- Median adherence at 1 year was 86% (interquartile range, 79%-93%).
- Systolic BP dropped by an average 9 mm Hg with polypill vs 2 mm Hg with usual care (P=.003).
- LDL-C mean dropped by 15 mg/dL with the polypill and 4 mg/dL with usual care (P<.001>
- 2% with polypill had therapy escalation vs 10% with usual care.
- 2 cardiac-related serious adverse events (1 stroke death, 1 coronary artery bypass surgery) occurred in the usual care group.
- Randomized controlled trial, polypill (n=148) vs usual care (n=155), among patients (mean age, ~56 years) attending a community health center in Alabama, December 2015-July 2017.
- Polypill (daily): atorvastatin (10 mg), amlodipine (2.5 mg), losartan (25 mg), hydrochlorothiazide (12.5 mg).
- Funding: American Heart Association; NIH.
- Open-label design.
- Single center.