Polypill for Population-Level Primary Cardiovascular Prevention in Underserved Populations—A Social Epidemiology Counterargument

Use of polypills combining multiple pharmacotherapies for cardiovascular disease prevention is a hot topic in cardiovascular medicine. In a low-resource, mostly black community in Alabama with an average 12% of 10-year cardiovascular disease risk, a pill combining a statin plus 3 antihypertensive medications that lowered blood pressure improved adherence and control of proximal risk factors.1 In Iran, a combination of aspirin, a statin, and 2 antihypertensive drugs reduced cardiovascular disease events in a mixed primary and secondary prevention population, including 11% individuals with established cardiovascular disease and 15% with diabetes, as compared to a “minimal care” intervention.