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For people at high risk of cardiovascular disease, many patients need to pay attention to blood pressure, blood lipids and other indicators at the same time.
recent years, the concept of "combination" cardiovascular drugs containing a variety of pharmaceutical components has been proposed.
2019, the Lancet and the New England Journal of Medicine published the results of the PolyIran study and the Southern Community Queue study, respectively, supporting the effective prevention of a significant portion of cardiovascular events.
, another heavy-weight study based on the compound drug concept, TIPS-3, announced the results. data from
across nine countries, covering more than 5,700 subjects, showed that taking multiple drugs containing four lipid-lowering, anti-hyperpressin and low-dose aspirins daily reduced the risk of heart attack, stroke and heart-related death by about a third.
was published simultaneously in the American Heart Association(AHA) 2020 Scientific Conference and the New England Journal of Medicine.
this will further promote the application of cardiovascular disease compound drug treatment strategies.
: The New England Journal of Medicine study was conducted in people who were not yet at high risk of cardiovascular disease due to high blood pressure, diabetes or other underlying diseases.
,713 patients from India, the Philippines, Colombia, Canada, Malaysia, Indonesia, Bangladesh, Tanzania and Tunisia.
the subjects, men were at least 50 years old and women were at least 55 years old.
study used a 2×2×2 predisposing design in which patients were randomly grouped to receive the compound drug "Polycap" (containing 40 mg of simvastatin, 100 mg of athilol, 25 mg of hydrochlorochloride and 10 mg of remipri) or placebo (daily); aspirin (75mg) or placebo (daily); vitamin D or placebo (monthly).
results, published today, focus on a comparison of compound drugs and aspirin and their combinations, and do not include an analysis of vitamin D.
outcomes are the effects on cardiovascular events, including cardiovascular death, heart attack, stroke, cardiac arrest, heart failure, or blood reconstruction.
aspirin (left) and Polycaps (right), a compound containing a cholesterol-lowering, three anti-hypernantigrade ingredients.
(Photo Source: McMaster University) After an average follow-up of 4.6 years, the data showed that compared to placebo: taking aspirin alone did not significantly alter the risk of cardiovascular events; %but not significant; while aspirin-linked compound drugs showed significant preventive value, low-density lipoprotein cholesterol (LDL-C) levels were reduced by about 19 mg/dL, systolic blood pressure was reduced by about 5.8 mm Hg, and the risk of cardiovascular events was significantly reduced by 31%.
the overall safety of the compound drug is good.
drug had fewer serious adverse events than placebos.
about 1.5 percent of compound drug takers experience dizziness or hypotension, but researchers can switch to lower doses to control adverse reactions.
importantly, there was no difference in major, secondary or gastrointestinal bleeding events between the compound drug-linked aspirin and placebo groups.
team speculated that two factors may have played a role: (1) the trial excluded people with a history of bleeding or gastrointestinal symptoms, and (2) the dose of aspirin was lower than that used in other level 1 prevention trials.
at the end of the study, only 5% of drug suspensions were due to side effects.
compliance problems in other patients were mainly due to delays in the production and distribution of compound drugs and the effects of the late-trial neo-crown outbreak.
Sensitivity analysis of subjects who did not stop for non-medical reasons showed that the benefits of combined aspirin were more pronounced, with a 39 percent reduction in the risk of cardiovascular events, which may more accurately reflect the actual benefits of this combination therapy.
Dr. Salim Yusuf, a professor of medicine at McMaster University in Canada and director of the Institute of Population Health and author of the study, said the results show that "the strategy for this compound drug applies to all countries, not just low-income areas."
if half of the world's suitable patients take these compound drugs, 3 to 5 million cardiovascular events will be avoided each year.
Eugene Yang, head of the AHA Cardiology Prevention Group and a cardiologist at the University of Washington, commented that "this study is very important" and that it is "the best data we have so far."
that the accumulation of these evidences will bring about positive changes in clinical practice and public health.
: salim Yusuf, et al., (2020). Polypill with or without Aspirin in Persons without Cardiovascular Disease. N Engl J Med, DOI: 10.1056/NEJMoa2028220[2] Big study supports cheap combo pill to lower heart risks. Retrieved November 16, 2020, from TIPS-3: Polypill Provides Meaningful Primary Cardiovascular Prevention. Retrieved November 16, 2020, from