Abstract 14078: The Use of Polypill Components in Clinical Practice in Patients With Vascular Diseases or Type 2 Diabetes Mellitus From 1996 to 2009
Introduction: Patients with manifest vascular disease are recommended to receive a combination of aspirin, cholesterol and blood pressure (BP) lowering agents. Combining these pharmacological agents into a single pill, the polypill, may optimize prescription rates and reduce non-adherence in high risk patients.
Objective: To assess the prevalence of use of a polypill combination of pharmacologic agents in clinical practice in patients with clinical manifest vascular diseases or type 2 diabetes mellitus (DM2) over time.
Methods: 5666 patients admitted with coronary artery disease (CAD), cerebrovascular disease (CVD), peripheral arterial disease (PAD), abdominal aortic aneurysm (AAA) or DM2 in the period 1996-2009 were included. Use of pharmacologic agents was classified into aspirin, statin and BP lowering agents.
Results: The overall use of combination therapy with aspirin, statin and >=1 BP lowering agent increased substantially from 9% in 1996 to 66% in 2009 (Figure 1). The use of the combination therapy with aspirin, statin and >=2 BP lowering agents increased from 1% to 48%. In 2009, the combination therapy with >=1 BP lowering agent was used by 83% in patients with CAD, 49% in patients with CVD, 32% in PAD patients, 43% in AAA patients and 25% in DM2. The use of combination treatment with >=2 BP lowering agents was 58%, 39%, 14%, 27% and 25% respectively in 2009. Other determinants for the use of combination treatment were age (OR 1.14 95%-CI:1.09-1.20 per 10-years), female gender (OR 1.33; 1.18-1.51) and BMI >30 kg/m2 (OR 1.36; 1.19-1.56) adjusted for age and gender if applicable.
Conclusion: In patients with clinical manifestations of vascular diseases and DM2 about 65% already uses the combination of pharmacological agents proposed for the polypill in 2009. Introduction of a polypill in these high risk patients may considerably improve use of preventive pharmacologic treatment and increase adherence to therapy.
- © 2010 by American Heart Association, Inc.