The Efficacy and Safety of Polypill on Cardiovascular Risk Factors: A Meta-analysis_West China Medical Journal

Authors：

 FANGDong ¹ , WANJing ² , FANGQi ¹ , LIKai-yong ¹ , CAOJian-lei ² , DINGSHILan-ying ¹ ,  GONGFei ²

1. The Second Clinical Medical College, Wuhan University, Wuhan, Hubei 430071, P. R. China;
2. Department of Cardiovascular Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P. R. China;

Corresponding author：

GONGFei, Email: gongfeimm@163.com

Keywords：

Polypill; Cardiovascular risk factors; Randomized controlled trials

DOI：

10.7507/1002-0179.20150303

Video：

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Objective To systematically evaluate the efficacy and safety of Polypill on cardiovascular risk factors. Method Such databases as Embase, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastracture, WanFang, and China Biology Medicine Disc were searched from their establishment to May 2015 for randomized controlled trials on the efficacy and safety of Polypillon on cardiovascular risk factors. Meta-analyses were performed by using the RevMan 5.2 software. Results Six studies were included which all came from overseas including 1 155 patients treated with Polypill and 1 149 treated with placebo or single or combined medicaiton. The meta-analysis showed that:when compared with the controls, Polypills could significantly reduce systolic blood pressure[WMD=-9.39 mm Hg (1 mm Hg=0.133 kPa), 95%CI (-14.44, -4.33) mm Hg, P=0.0003], diastolic blood pressure[WMD=-5.32 mm Hg, 95%CI (-8.10, -2.55) mm Hg, P=0.0002], total cholesterol[WMD=-1.11 mmol/L, 95%CI (-1.48, -0.74) mmol/L, P<0.00001], and low density lipoprotein[WMD=-0.91 mmol/L, 95%CI (-1.25, -0.57) mmol/L, P<0.00001]. However, those who took Polypill were easier to discontinue medication [OR=1.49, 95%CI (1.19, 1.87), P=0.0005]. In the respect of adverse effects, there was no significant difference between the two groups[OR=1.47, 95%CI (0.67, 3.25), P=0.34]. Conclusions The efficacy of Polypill on cardiovascular risk factors is obvious. Polypills can significantly reduce blood pressure and lipids. Tolerability is lower in those taking Polypills, but the difference is minor. There is no significant difference in the respect of adverse effects.

Citation： FANGDong, WANJing, FANGQi, LIKai-yong, CAOJian-lei, DINGSHILan-ying, GONGFei. The Efficacy and Safety of Polypill on Cardiovascular Risk Factors: A Meta-analysis. West China Medical Journal, 2015, 30(6): 1054-1059. doi: 10.7507/1002-0179.20150303 Copy

1.	田代华. 使用中药辞典:下卷[M]. 北京:人民卫生出版社, 2002:1338, 1897.
2.	尹俊亭, 仲英, 孙敬勇, 等. 葛花化学成分的研究(Ⅰ)[J]. 中草药, 2006, 37(3):350-352.
3.	张淑萍, 贺云, 刘柏涛. RP-HPLC测定野葛花中3种异黄酮[J]. 分析试验室, 2006, 25(2):74-76.
4.	Kulkarni SP, Alexander KP, Lytle B, et al. Long-term adherence with cardiovascular drug regimens[J]. Am Heart J, 2006, 151(1):185-191.
5.	Yusuf S. Two decades of progress in preventing vascular disease[J]. Lancet, 2002, 360(9326):2-3.
6.	Jadad AR, Moore RA, Carroll D, et al. Assessing te quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
7.	Colditz GA, Burdick E, Mosteller F. Heterogeneity in meta-analysis of data from epidemiologic studies:a commentary[J]. Am J Epidemiol, 1995, 142(4):371-382.
8.	Indian Polycap Study (TIPS), Yusuf S, Pais P, et al. Effects ofa Polypill (Polycap) on risk factors in middle-aged individuals without cardiovascular disease (TIPS):a phase Ⅱ, double-blind, randomised trial[J]. Lancet, 2009, 373(9672):1341-1351.
9.	Grimm R, Malik M, Yunis C, et al. Simultaneous treatment to attain blood pressure and lipid goals and reduced CV risk burden using amlodipine/atorvastatin single-pill therapy in treated hypertensive participants in a randomized controlled trial[J]. Vasc Health Risk Manag, 2010, 6:261-271.
10.	Malekzadeh F, Marshall T, Pourshams A, et al. A pilot double-blind randomised placebo-controlled trial of the effects of fixed-dose combination therapy ("Polypill") on cardiovascular risk factors[J]. Int J ClinPract, 2010, 64(9):1220-1227.
11.	Soliman EZ, Mendis S, Dissanayake WP, et al. A Poly pill for primary prevention of cardiovascular disease:a feasibility study of the World Health Organization[J]. Trials, 2011, 12:3.
12.	PILL Collaborative Group, Rodgers A, Patel A, et al. An international randomised placebo-controlled trial of a four-component combination pill ("Polypill") in people with raised cardiovascular risk[J]. PLoS One, 2011, 6(5):e19857.
13.	Wald DS, Morris JK, Wald NJ. Randomized Polypill crossover trial in people aged 50 and over[J]. PLoS one, 2012, 7(7):e41297.
14.	Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%[J]. BMJ, 2003, 326(7404):1419.
15.	曹东来, 杨向军. PCI术后冠心病患者他汀类药依从性分析[J]. 中国血液流变学杂志, 2004, 14(1):126-127.
16.	De Berardis G, Lucisano G, D'ettorre A, et al. Association of aspirin use with major bleeding in patients with and without diabetes[J]. JAMA, 2012, 307(21):2286-2294.

1. 田代华. 使用中药辞典:下卷[M]. 北京:人民卫生出版社, 2002:1338, 1897.
2. 尹俊亭, 仲英, 孙敬勇, 等. 葛花化学成分的研究(Ⅰ)[J]. 中草药, 2006, 37(3):350-352.
3. 张淑萍, 贺云, 刘柏涛. RP-HPLC测定野葛花中3种异黄酮[J]. 分析试验室, 2006, 25(2):74-76.
4. Kulkarni SP, Alexander KP, Lytle B, et al. Long-term adherence with cardiovascular drug regimens[J]. Am Heart J, 2006, 151(1):185-191.
5. Yusuf S. Two decades of progress in preventing vascular disease[J]. Lancet, 2002, 360(9326):2-3.
6. Jadad AR, Moore RA, Carroll D, et al. Assessing te quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
7. Colditz GA, Burdick E, Mosteller F. Heterogeneity in meta-analysis of data from epidemiologic studies:a commentary[J]. Am J Epidemiol, 1995, 142(4):371-382.
8. Indian Polycap Study (TIPS), Yusuf S, Pais P, et al. Effects ofa Polypill (Polycap) on risk factors in middle-aged individuals without cardiovascular disease (TIPS):a phase Ⅱ, double-blind, randomised trial[J]. Lancet, 2009, 373(9672):1341-1351.
9. Grimm R, Malik M, Yunis C, et al. Simultaneous treatment to attain blood pressure and lipid goals and reduced CV risk burden using amlodipine/atorvastatin single-pill therapy in treated hypertensive participants in a randomized controlled trial[J]. Vasc Health Risk Manag, 2010, 6:261-271.
10. Malekzadeh F, Marshall T, Pourshams A, et al. A pilot double-blind randomised placebo-controlled trial of the effects of fixed-dose combination therapy ("Polypill") on cardiovascular risk factors[J]. Int J ClinPract, 2010, 64(9):1220-1227.
11. Soliman EZ, Mendis S, Dissanayake WP, et al. A Poly pill for primary prevention of cardiovascular disease:a feasibility study of the World Health Organization[J]. Trials, 2011, 12:3.
12. PILL Collaborative Group, Rodgers A, Patel A, et al. An international randomised placebo-controlled trial of a four-component combination pill ("Polypill") in people with raised cardiovascular risk[J]. PLoS One, 2011, 6(5):e19857.
13. Wald DS, Morris JK, Wald NJ. Randomized Polypill crossover trial in people aged 50 and over[J]. PLoS one, 2012, 7(7):e41297.
14. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%[J]. BMJ, 2003, 326(7404):1419.
15. 曹东来, 杨向军. PCI术后冠心病患者他汀类药依从性分析[J]. 中国血液流变学杂志, 2004, 14(1):126-127.
16. De Berardis G, Lucisano G, D'ettorre A, et al. Association of aspirin use with major bleeding in patients with and without diabetes[J]. JAMA, 2012, 307(21):2286-2294.

West China Medical Journal

The Efficacy and Safety of Polypill on Cardiovascular Risk Factors: A Meta-analysis

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