Polypill as a means of population pharmacological prevention of cardiovascular diseases

P. A. Lebedev, I. K. Petruhina, E. V. Paranina
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Abstract

Non-communicable diseases, among which arterial hypertension and ischemic heart disease are the predominant contributors to disability and mortality, have long been identified as a strategic target of preventive intervention in our country. The situation is aggravated by covid-19 associated mortality, which is characterized by delayed dynamics and is largely related to cardiovascular. Excess mortality, in the structure of which cardiovascular diseases are leading, requires new solutions. One of them is population pharmacoprevention, based on the use of complex fixed combinations of drugs targeting different risk factors, as arterial hypertension and dyslipidemia, as most important. This concept, which logically follows from modern realities, is in contradiction with the existing approach of personalized therapy in high/very high risk groups, because of its complexity, leading to patients noncompliance. The new system of cardiovascular risk stratification SCORE 2 introduced in the Russian Federation significantly contributes to the spread of the concept of polypills as a unified approach primarily in the most vulnerable population of males 50 years and older.
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作为心血管疾病人群药物预防手段的多丸剂
非传染性疾病,其中动脉高血压和缺血性心脏病是导致残疾和死亡的主要因素,早已被确定为我国预防干预的战略目标。而 19 型冠心病相关死亡率则加剧了这一状况,其特点是动态延迟,主要与心血管有关。在死亡率过高的结构中,心血管疾病占主导地位,因此需要新的解决方案。其中之一就是人群药物预防,其基础是针对不同的危险因素,如最重要的动脉高血压和血脂异常,使用复杂的固定组合药物。从逻辑上讲,这一概念源于现代现实,但却与现有的针对高危/极高危人群的个性化治疗方法相矛盾,因为其复杂性导致患者不配合治疗。俄罗斯联邦引入的新的心血管风险分层系统 SCORE 2 极大地促进了多丸剂概念的传播,使其成为主要针对 50 岁及以上男性这一最脆弱人群的统一方法。
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