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Clinical Effectiveness of the Cardiovascular Polypill in a Real-Life Setting in Patients with Cardiovascular Risk: The SORS Study

2019; Elsevier BV; Volume: 50; Issue: 1 Linguagem: Inglês

10.1016/j.arcmed.2019.04.001

1873-5487

José M. Castellano, Juan Verdejo, Salvador Ocampo, Marco Martínez Ríos, Enrique Gómez-Álvarez, Gabriela Borrayo, Emilio Muñoz Ruiz, Borja Ibáñez, Valentı́n Fuster, Misael Arroyo, Maria Teresa Colosia, Juan E. Becerril, Roberto Vázquez, Elías Rodríguez Rodríguez, Alejandro Domínguez-Rodríguez, Rafael Márquez, Enrique Gómez‐Figueroa, Juan Marcos González, Jose L. Ubiarco, Jose Fernando Rincón Barrera, Bertha Vitela, Laura A. Aranda, Victor Waldez Hernandez Peña, Miguel Ángel López Guerrero, Susana Ibarra, Maria I. Córdoba, Gloria Ledesma, Gustavo A. Alarcón, Jose A. Campos, José Luis Díez Gil, Rafael Elias, Víctor H. Báez, Mariano D. Cervantes, Raúl Apresa, Javier Casian, Rafael Serrano del Rosal, David A. Delgado, Joel E. Padrón, Víctor Manuel Vargas Hernández, Maria Antonia Rodriguez, Enrique González, Alejandro García, Francisco Javier González, Miguel A. González, Nadia Álvarez, Jorge Rodríguez, Francisco Martínez‐Martínez, Jose A. Gaxiola, Luis García, Luís Gonzaga, Mirtha Valenzuela, Ezequiel García, Manuel Anguita Sánchez, Manuel González Oropeza, Simón Areola, Guillermo A. Rodríguez, Maria R. Zarate, Maria R. Jaramillo, A. Molina, Félix González, Marisela C. Parra, Rosalba Lara, Delia Ruiz, Alejandro Chávez, Héctor V. Ballardo, Ezequiel Gomez, Antonio Corona, Mario L. Rodriguez, Ramón Flores, José Alberto Castro, Reynaldo J. Jiménez, Jesús M. Acosta, A. Lucía Morales, Enrique A. Velázquez, Gerardo Santana, Juan J. Atilano, María Jiménez, Fernando Rodríguez González, Jose J. Santos, Maria A. Asmida, José Carlos Flores, Raúl Segura, Isilio N. Morales, Javier Solis Estrada, Jorge L. Narváez, Silvia Rivera, Jorge L. Flores, Norma E. Cano, Miguel Ángel López Guerrero, Armando Moreno, Armando G. de la Cruz, Noé D. Monroy, Omar John B. Mejia, Joaquín I. Moreno, Martin Limas, J. Maldonado, Vania Quisbert, Claudia C. Rojas, Mario Flores, Sonia Medina Salgado, Ana K. Villanueva, U Yajaira Romero, Alejandro Daniel Pedraza Tirado, Maria C. Guadalupe, J Villalpando, Alejandro Cortes, Eliceo Gracia, Karla G. Wong, Víctor M. Salas, Jose L. Escobar, Pedro Hernández, Nancy Bello, Rubén O. Yza, Octavio Beltrán, Miguel A. Águila, Francisco Vera‐Sempere, P. A. Rueda Mejia, Juan M. Arellano, Enrique Morlet, Luis E. López, Marco Antonio Martínez‐Ríos, Federico Jimenez‐Ruiz, Yolanda P. Rodriguez, Javier Freire, Alejandro Rivas, Beatriz Mendoza, Sergio Téllez, José Antonio Magaña, Juan A. Quintana, Lázaro Aguilar, Jose Sacen, Edith MC. Vallarta, Fernando Flores García, María Luisa Pimentel Ramírez, Maria T. Olac, German R. Bautista, Juan F. Martı́n, Marcelo Jiménez, Jorge Martínez Cedillo, Eddie A. Favela, Jose Pegueros, José Juan Gómez Becerra, Raul Silva, Armando Zepeda, Jorge Ezequiel Hernández Hernández, Miguel Marvaes, Hilario Flores Aguilar, Ana L. Lerma, Luis Matías Zabala Fuentes,

Pharmaceutical Practices and Patient Outcomes

The cardiovascular disease pandemic has promoted the cardiovascular polypill as one of the most scalable public health strategies to improve cardiovascular risk by increasing accessibility and adherence to treatments. Data from randomized clinical trials has shown that the polypill strategy significantly improves adherence as well as risk factor control (cholesterol and blood pressure), however, to date, no information from phase IV registries has been available. We conducted a multicentre, observational and prospective registry of a polypill-based treatment strategy. A total of 1193 patients in Mexico were included. Patient demographics, clinical history, blood pressure, analysis of blood lipids and the Framingham risk score were measured at baseline and after 12 months of treatment with the CNIC-Ferrer polypill. At one year with the polypill, systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels changed from mean 146.9 mmHg to 128 mmHg (p <0.001), and from 89.1 mmHg to 80.4 mmHg (p <0.001) respectively. LDLc levels were significantly reduced 132.5–107.6 mg/dL (p <0.001). The 10 year Framingham cardiovascular disease risk was also reduced in the high-risk group (33.7 + 22.0 vs. 21.2 + 14.8; p <0.001) and in the intermediate risk group (23.7 + 14.8 vs. 12.7 + 11.4; p <0.001). To our knowledge, the results of the current study constitute the first real life data on the impact of a polypill therapy on cardiovascular risk factor control. The results show major improvements on the primary outcome, above and beyond those presented previously in the setting of randomized clinical trials.