Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, London, UK.
J Eval Clin Pract. 2012 Jun;18(3):612-5. doi: 10.1111/j.1365-2753.2011.01637.x. Epub 2011 Jan 30.
A combination of medications that simultaneously reduce several cardiovascular risk factors in people above a specified age, without selection based on risk factor measurement, has been proposed as a simple strategy for reducing the risk of cardiovascular disease and shown to be effective in randomized trials (the Polypill approach).
To assess acceptance of the Polypill approach and adherence to preventive treatment among individuals taking part in a cardiovascular disease prevention service.
Daily treatment with simvastatin (40 mg), amlodipine (2.5 mg), bendroflumethiazide (1.25 mg), lisinopril (5 mg) [or candesartan (4 mg) if cough was reported] and folic acid (0.8 mg) was offered, as separate components, to people ≥ 55 years with no history of cardiovascular, renal or liver disease. An audit of adverse effects, adherence and requests for blood pressure and cholesterol measurement was determined by telephone consultation.
Between 2006 and 2010, 269 participants started treatment with the Polypill components. Follow-up ranged from 3 to 48 months (mean 20). A total of 222 participants (83%) adhered to treatment, including 30 (11%) who switched from the angiotensin-converting enzyme inhibitor (lisinopril) to the angiotensin receptor blocker (candesartan) because of cough. Ten participants (4%) continued to take treatment but stopped taking one or more drugs because of other symptoms, and 37 (14%) stopped all treatment, eight because of adverse effects and 29 for non-medical reasons. No one requested a blood pressure or cholesterol measurement.
This is the first demonstration of the application of the Polypill approach in practice. The method was accepted and the Polypill components were well tolerated, with good adherence and no demand for information about risk factors.
在特定年龄以上的人群中，同时使用几种药物来降低多种心血管风险因素，而不根据风险因素测量进行选择，这种联合用药方案被提议作为一种降低心血管疾病风险的简单策略，并且在随机试验中已被证明是有效的（即 polypill 方法）。
评估参与心血管疾病预防服务的个体对 polypill 方法的接受程度和对预防治疗的依从性。
向无心血管、肾脏或肝脏疾病病史的≥55 岁人群提供单独的辛伐他汀（40mg）、氨氯地平（2.5mg）、苄氟噻嗪（1.25mg）、赖诺普利（5mg）[或坎地沙坦（4mg），如果报告有咳嗽]和叶酸（0.8mg）的治疗。通过电话咨询确定药物不良反应、依从性以及血压和胆固醇测量的请求的审核。
在 2006 年至 2010 年间，有 269 名参与者开始服用 polypill 成分药物。随访时间为 3 至 48 个月（平均 20 个月）。共有 222 名参与者（83%）坚持治疗，包括 30 名（11%）因咳嗽而从血管紧张素转换酶抑制剂（赖诺普利）转换为血管紧张素受体阻滞剂（坎地沙坦）的参与者。10 名参与者（4%）继续服用治疗药物，但因其他症状停止服用一种或多种药物，37 名参与者（14%）停止了所有治疗，8 名参与者因不良反应停止治疗，29 名参与者因非医疗原因停止治疗。没有人要求测量血压或胆固醇。
这是 polypill 方法首次在实践中的应用。该方法被接受，polypill 成分耐受性良好，依从性好，且对危险因素信息没有需求。
