Clínica de Enfermedad Coronaria e Insuficiencia Cardiaca, Servicio de Cardiología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico.
Servicio de Cardiología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico.
PLoS One. 2023 Aug 25;18(8):e0290544. doi: 10.1371/journal.pone.0290544. eCollection 2023.
Pharmacological treatment with lipid-lowering and antihypertensive drugs has been proposed as a strategy to improve excess cardiovascular (CV) risk among obese individuals. The present study aimed to assess whether the CV polypill (Sincronium®) could be an effective strategy to help improve CV risk factor control in obese/overweight individuals requiring secondary prevention.
This was an observational, retrospective study reviewing the hospital medical records of 479 patients with established CV disease who initiated treatment with the CV polypill between 2013 and 2019 at a general hospital in Mexico. Patients were grouped as normal weight, overweight or obese according to their initial body mass index (BMI). We collected blood pressure (BP), lipid profile, and vascular age at the last visit recorded during the period following treatment.
At the end of the study, all assessed lipid parameters improved compared to baseline regardless of the initial BMI category (all p<0.001). There was an increase from baseline regarding the proportion of patients with at target low-density lipoprotein cholesterol after treatment (2.3% vs. 30.1%; p<0.001), more than 80% of patients achieved triglyceride levels <200 mg/dL (p<0.001), and more than 80% achieved target BP levels in all BMI subgroups (p<0.001). The subanalyses in the elderly population yielded similar results, with a significant overall improvement in lipid and BP control after initiating the CV polypill strategy.
The use of the CV polypill as baseline therapy for secondary prevention seems to be a reasonable strategy that enhances CV risk factor control regardless of the patient's BMI.
降脂和降压药物的药理学治疗已被提议作为改善肥胖个体心血管(CV)风险过高的策略。本研究旨在评估心血管复方药(Sincronium®)是否可以作为一种有效的策略,帮助改善需要二级预防的肥胖/超重个体的心血管风险因素控制。
这是一项观察性、回顾性研究,回顾了 2013 年至 2019 年期间在墨西哥一家综合医院接受心血管复方药治疗的 479 例已确诊心血管疾病患者的医院病历。根据初始体重指数(BMI),患者被分为正常体重、超重或肥胖。我们收集了最后一次就诊时的血压(BP)、血脂谱和血管年龄。
在研究结束时,与基线相比,所有评估的血脂参数均有所改善,无论初始 BMI 类别如何(均 p<0.001)。与治疗前相比,治疗后达到目标低密度脂蛋白胆固醇的患者比例有所增加(2.3% vs. 30.1%;p<0.001),超过 80%的患者达到了甘油三酯水平<200mg/dL(p<0.001),并且所有 BMI 亚组均达到了目标 BP 水平(p<0.001)。在老年人群中的亚组分析得出了类似的结果,表明在启动心血管复方药策略后,血脂和 BP 控制得到了显著改善。
将心血管复方药作为二级预防的基础治疗似乎是一种合理的策略,无论患者的 BMI 如何,都可以增强心血管风险因素控制。