
Polypills for the prevention of cardiovascular disease: a framework for wider use
Cardiovascular diseases (CVDs) are the leading cause of premature death and disability globally, with disease burden continuing to rise in low- and middle-income countries (LMICs)1. Safe and effective preventive treatments for CVDs, such as blood-pressure-lowering drugs, statins and aspirin, have been available for decades. However, most people in LMICs that are at sufficiently increased CVD risk to warrant use of these medications do not receive them2,3. Even among those at greatest risk, namely those who have survived a prior CVD event, only a small minority receive most recommended medicines and most receive no treatment whatsoever2. Similarly, for people with hypertension — which affects more than a billion people globally — most individuals do not receive any treatment,
let alone the multiple drugs usually required for adequate blood pressure control4.