Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management
Although various guidelines for cardiovascular disease prevention have been established, the optimal drug therapy is often not implemented due to poor medication adherence and the clinical inertia of healthcare practitioners. Polypill strategies are one solution to this problem. Previous studies hav...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7226 |
| _version_ | 1797399983679340544 |
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| author | Keisuke Narita Satoshi Hoshide Kazuomi Kario |
| author_facet | Keisuke Narita Satoshi Hoshide Kazuomi Kario |
| author_sort | Keisuke Narita |
| collection | DOAJ |
| description | Although various guidelines for cardiovascular disease prevention have been established, the optimal drug therapy is often not implemented due to poor medication adherence and the clinical inertia of healthcare practitioners. Polypill strategies are one solution to this problem. Previous studies have established the usefulness of polypills, i.e., combination tablets including three or more medications, for the prevention of cardiovascular disease. For this purpose, the polypills generally contain an antiplatelet medication, an antihypertensive medication, and a statin. For the specific management of hypertension, combination therapy including more than two classes of antihypertensive medications is recommended by most international guidelines. Combination tablets including two classes of antihypertensive medications, such as renin-angiotensin system (RAS) inhibitors (angiotensin-converting enzyme inhibitors [ACEIs] and angiotensin receptor blockers [ARBs]) and Ca-channel blockers or thiazide diuretics, have been reported to be useful for cardiovascular disease prevention and lowering blood pressure (BP) levels. The use of RAS inhibitors is recommended for a wide range of complications, including diabetes, chronic heart failure, and chronic kidney disease. The combination of an RAS inhibitor and diuretic or Ca-channel blocker is thus recommended for the management of hypertension. Finally, we expect that novel medications such as angiotensin receptor neprilysin inhibitors (ARNIs) and sodium glucose cotransporter 2 inhibitors (SGLT2i), which have a more diverse range of effects in hypertension, heart failure, or diabetes, may be a solution to the problem of polypharmacy. Evidence is accumulating on the benefits of polypill strategies in cardiovascular disease prevention. Combination tablets are also effective for the treatment of hypertension. |
| first_indexed | 2024-03-09T01:48:59Z |
| format | Article |
| id | doaj.art-818595bdbbba4c34a0f99d814a7003e4 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:48:59Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-818595bdbbba4c34a0f99d814a7003e42023-12-08T15:18:41ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223722610.3390/jcm12237226Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension ManagementKeisuke Narita0Satoshi Hoshide1Kazuomi Kario2Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Shimotsuke 329-0498, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Shimotsuke 329-0498, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Shimotsuke 329-0498, JapanAlthough various guidelines for cardiovascular disease prevention have been established, the optimal drug therapy is often not implemented due to poor medication adherence and the clinical inertia of healthcare practitioners. Polypill strategies are one solution to this problem. Previous studies have established the usefulness of polypills, i.e., combination tablets including three or more medications, for the prevention of cardiovascular disease. For this purpose, the polypills generally contain an antiplatelet medication, an antihypertensive medication, and a statin. For the specific management of hypertension, combination therapy including more than two classes of antihypertensive medications is recommended by most international guidelines. Combination tablets including two classes of antihypertensive medications, such as renin-angiotensin system (RAS) inhibitors (angiotensin-converting enzyme inhibitors [ACEIs] and angiotensin receptor blockers [ARBs]) and Ca-channel blockers or thiazide diuretics, have been reported to be useful for cardiovascular disease prevention and lowering blood pressure (BP) levels. The use of RAS inhibitors is recommended for a wide range of complications, including diabetes, chronic heart failure, and chronic kidney disease. The combination of an RAS inhibitor and diuretic or Ca-channel blocker is thus recommended for the management of hypertension. Finally, we expect that novel medications such as angiotensin receptor neprilysin inhibitors (ARNIs) and sodium glucose cotransporter 2 inhibitors (SGLT2i), which have a more diverse range of effects in hypertension, heart failure, or diabetes, may be a solution to the problem of polypharmacy. Evidence is accumulating on the benefits of polypill strategies in cardiovascular disease prevention. Combination tablets are also effective for the treatment of hypertension.https://www.mdpi.com/2077-0383/12/23/7226polypill strategycombination medication therapycardiovascular preventionblood pressurehypertension |
| spellingShingle | Keisuke Narita Satoshi Hoshide Kazuomi Kario Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management Journal of Clinical Medicine polypill strategy combination medication therapy cardiovascular prevention blood pressure hypertension |
| title | Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management |
| title_full | Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management |
| title_fullStr | Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management |
| title_full_unstemmed | Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management |
| title_short | Polypill Therapy for Cardiovascular Disease Prevention and Combination Medication Therapy for Hypertension Management |
| title_sort | polypill therapy for cardiovascular disease prevention and combination medication therapy for hypertension management |
| topic | polypill strategy combination medication therapy cardiovascular prevention blood pressure hypertension |
| url | https://www.mdpi.com/2077-0383/12/23/7226 |
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