September 19, 2019
A polypill that contains low doses of atorvastatin, amlodipine, losartan, and hydrochlorothiazide can reduce systolic blood pressure (SBP) and low-density lipoprotein (LDL) cholesterol levels in adult minorities with low socioeconomic status, according to a new study.
To assess the effect of a polypill-based strategy on underserved communities, the researchers studied data from 303 adults without cardiovascular disease (CVD). Of these participants, 96.0% were black, and approximately 75.0% had an annual income less than $15,000.
The participants were randomly assigned to receive either a polypill that contained atorvastatin, 10 mg; amlodipine, 2.5 mg; losartan, 25 mg; and hydrochlorothiazide, 12.5 mg, or usual care at a federally qualified community health center in Alabama.
The researchers measured the participants’ changes in SBP and LDL cholesterol levels from baseline to 12 months.
At baseline, mean BP was 140/83 mm Hg and mean LDL cholesterol level was 113 mg/dL. The mean estimated 10-year CVD risk was 12.7%.
Overall, the monthly cost of the polypill was $26. Based on pill counts, the researchers determined that adherence to the polypill was 86.0% at 12 months.
Participants taking the polypill had a 9 mm Hg decrease in mean SBP. Meanwhile, those in the usual care group had a decrease in mean SBP of 2 mm Hg.
Participants taking the polypill also had a greater decrease in mean LDL cholesterol level compared with those in the usual care group (-15 mg/dL vs -4 mg/dL, respectively).
“A polypill-based strategy led to greater reductions in systolic blood pressure and LDL cholesterol level than were observed with usual care in a socioeconomically vulnerable minority population,” the researchers concluded.
Muñoz D, Uzoije P, Reynolds C, et al. Polypill for cardiovascular disease prevention in an underserved population. N Engl J Med. 2019;381(12):1114-1123. doi:10.1056/NEJMoa1815359.