降低低收入和中等收入国家心血管疾病的过早死亡率:复方药丸在公共卫生政策中的作用。
Reducing premature mortality from cardiovascular diseases in low and middle income countries: The role of Polypill in public health policy.
作者信息
Sepanlou Sadaf G, Mousavi SeyedehFatemeh, Poustchi Hossein, Malekzadeh Fatemeh, Roshandel Gholamreza, Malekzadeh Reza
机构信息
Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, 1417713135, Iran.
Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, 1417713135, Iran.
出版信息
Int J Cardiol Cardiovasc Risk Prev. 2025 Apr 3;25:200400. doi: 10.1016/j.ijcrp.2025.200400. eCollection 2025 Jun.
Premature deaths account for about half of all fatalities in developing countries. In low- and middle-income countries, cardiovascular diseases have consistently been the primary cause of premature mortality for men and women during the past three decades. Current evidence indicates that fixed-dose combination therapy, the so-called Polypill, effectively reduces the burden of cardiovascular diseases, with greater benefits observed in combinations that include aspirin. Polypill demonstrates high adherence and an acceptable safety profile, with adverse drug events being comparable between the groups receiving treatment and those in the control group. Therefore, this paper advocates for the broader implementation of Polypill in low and middle-income countries, emphasizing its efficacy in the primary and secondary prevention of cardiovascular diseases. The strategy could also benefit high-risk groups with special conditions, such as non-alcoholic fatty liver disease and chronic kidney disease. The cost-effectiveness of Polypill and its potential to address health inequities in low and middle-income countries underscore its value as a public health strategy. Policymakers are encouraged to consider Polypill as a viable option to enhance cardiovascular health outcomes and reduce premature deaths in low-resource settings.
在发展中国家,过早死亡约占所有死亡人数的一半。在低收入和中等收入国家,在过去三十年中,心血管疾病一直是男性和女性过早死亡的主要原因。目前的证据表明,固定剂量复方疗法,即所谓的“多效药丸”,能有效减轻心血管疾病负担,在包含阿司匹林的组合中观察到更大益处。“多效药丸”显示出高依从性和可接受的安全性,接受治疗组与对照组的药物不良事件相当。因此,本文主张在低收入和中等收入国家更广泛地应用“多效药丸”,强调其在心血管疾病一级和二级预防中的疗效。该策略也可能使患有特殊病症的高危群体受益,如非酒精性脂肪性肝病和慢性肾脏病。“多效药丸”的成本效益及其在低收入和中等收入国家解决健康不平等问题的潜力凸显了其作为一项公共卫生策略的价值。鼓励政策制定者将“多效药丸”视为在资源匮乏地区改善心血管健康结果和减少过早死亡的可行选择。