Clinical Effectiveness of the Cardiovascular Polypill in a Real-Life Setting in Patients With Cardiovascular Risk in Mexico: The SORS Study
Por:
Castellano J.M., Verdejo J., Ocampo S., Rios M.M., Gómez-Álvarez E., Borrayo G., Ruiz E., Ibáñez B., Fuster V.
Publicada:
1 ene 2019
Categoría:
Medicine (miscellaneous)
Resumen:
Background: 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. Methods: 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. Results: 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). Conclusions: 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. © 2019 IMSS
Filiaciones:
Castellano J.M.:
Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Montepríncipe, Grupo HM Hospitales, Madrid, Spain
Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain
Verdejo J.:
Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chavez, Ciudad de México, Mexico
Ocampo S.:
Hospital Angeles Lindavista, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
Rios M.M.:
Departamento de Cardiología, Instituto Nacional de Cardiología Ignacio Chavez, Ciudad de México, Mexico
Gómez-Álvarez E.:
Servicio de Cardiología del Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, Mexico
Borrayo G.:
División de la Coordinación de Unidades Médicas de Alta Especialidad, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
Ruiz E.:
Departamento Médico, Ferrer Internacional, Barcelona, Spain
Ibáñez B.:
Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Departamento de Cardiología, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain
Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Fuster V.:
Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Cardiovascular Institute, the Mount Sinai Medical Center, New York, United States
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