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Fixed dose combinations of cardiovascular drugs

BMJ 2014; 348 doi: (Published 27 May 2014) Cite this as: BMJ 2014;348:g3480
  1. Mark D Huffman, assistant professor
  1. 1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  1. m-huffman{at}

One of the most feasible ways to improve adherence

Drug treatment for cardiovascular disease remains inadequate globally,1 and many adults with cardiovascular disease or a high risk of cardiovascular disease receive no drug treatment. In response, the World Health Organization and its member states have agreed on a target to treat 50% of eligible adults with a multidrug regimen by 2025 as part of its wider “25×25” goal: to reduce the burden of premature, non-communicable, chronic diseases by 25% by 2025.2

Fixed dose combinations, or polypills, combine multiple drugs into one tablet and often include an antiplatelet agent, a lipid lowering drug, and at least one blood pressure lowering drug. Fixed dose combinations improve adherence to treatment for people with hypertension and HIV by approximately 25%.3 They are also an attractive drug delivery mechanism for adults with cardiovascular disease, not just to achieve the 50% drug treatment and premature mortality targets of the 25×25 goal but more specifically to reduce the global burden of cardiovascular disease.

In a linked paper, Selak and colleagues (doi:10.1136/bmj.g3318) sought to evaluate the effect of two fixed dose combination treatments on self reported adherence, blood pressure, and lipid levels in primary care patients from New Zealand with cardiovascular disease or a high risk …

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