Polypill for Population-Level Primary Cardiovascular Prevention in Underserved Populations at Heterogeneous Risk — 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 average 12% 10-year cardiovascular disease risk, a pill combining a statin plus three blood pressure-lowering medications improved adherence and control of proximal risk factors.1 In Iran, a combination of aspirin, a statin and two anti-hypertensive drugs reduced cardiovascular disease events in a mixed primary/secondary prevention population including 11% individuals with established cardiovascular disease and 15% with diabetes, as compared to a “minimal care” intervention.