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Polypills in Cardiovascular Disease Prevention: Mass-Strategy Approach, Precision Medicine, or an Essential Intertwine Between Them?

  • Evidence-Based Medicine, Clinical Trials and Their Interpretations (K. Nasir, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review considers the framework of high-risk vs. population approaches as proposed in the Rose’s axiom within the context of cardiovascular diseases, including its benefits and limitations. We also contextualize the use of precision medicine in primary prevention therapy and contrast that with population approach.

Recent Findings

Although the high-risk strategy aims at individualized care, the complexity of pharmacologic regimens and other limitations reduces its real-life impact. On the other hand, broad population strategies include treatment of a substantial number of low-risk individuals who are unlikely to benefit from treatment. The use of additional strategies to identify those low-risk individuals, instead of targeting at identifying the high-risk population, is and alternative strategy to be considered. Evidence of the potential use of coronary artery calcium score and polypills for this strategy is discussed.

Summary

A more targeted population approach to primary prevention in cardiovascular diseases with the use of polypills and coronary artery calcium score might be considered in a structured mass-strategy approach to risk reduction.

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Authors and Affiliations

  1. Division of Internal Medicine, University Hospital, University of São Paulo, Av. Lineu Prestes, 2565, CEP, São Paulo, 05508-000, Brazil

    Giuliano Generoso & Marcio Sommer Bittencourt

  2. DASA, São Paulo, Brazil

    Marcio Sommer Bittencourt

Authors
  1. Giuliano Generoso
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  2. Marcio Sommer Bittencourt
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Correspondence to Marcio Sommer Bittencourt.

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Conflict of Interest

Dr. Generoso has nothing to disclose.

Dr. Bittencourt reports grants from Sanofi, and personal fees from GE HealthCare, EMS, and NovoNordisk.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Generoso, G., Bittencourt, M.S. Polypills in Cardiovascular Disease Prevention: Mass-Strategy Approach, Precision Medicine, or an Essential Intertwine Between Them?. Curr Atheroscler Rep 23, 18 (2021). https://doi.org/10.1007/s11883-021-00917-4

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  • DOI: https://doi.org/10.1007/s11883-021-00917-4

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