A "poly-portfolio" for secondary prevention: a strategy to reduce subsequent events by up to 97% over five years

Jennifer G Robinson; Nidhi Maheshwari

doi:10.1016/j.amjcard.2004.09.036

Back

A "poly-portfolio" for secondary prevention: a strategy to reduce subsequent events by up to 97% over five years

Journal article

Peer reviewed

A "poly-portfolio" for secondary prevention: a strategy to reduce subsequent events by up to 97% over five years

Jennifer G Robinson and Nidhi Maheshwari

The American journal of cardiology, Vol.95(3), pp.373-378

02/01/2005

DOI: 10.1016/j.amjcard.2004.09.036

PMID: 15670547

View Online

Abstract

A "polypill" for the primary prevention of cardiovascular disease has been proposed. We estimated the projected benefit of a secondary prevention "poly-portfolio" strategy, including pharmacologic and lifestyle approaches for those with coronary heart disease (CHD) or stroke. Based on recent clinical trial results and clinical guidelines, combinations of a high-dose statin, low to standard doses of antihypertensive therapy, aspirin, omega-3 fish oil, cardiac rehabilitation, and diet were evaluated. Patients with CHD, post-myocardial infarction (MI), or stroke were projected to experience 84%, 91%, and 77% reductions, respectively, in CHD events from a pharmacologic approach. Numbers of those needed to treat (NNT) for 5 years were 9 to 11 to prevent 1 CHD event, and 21 to prevent 1 stroke. Post-MI patients were projected to experience a 93% reduction in the risk of CHD death (NNT 16) from a pharmacologic approach and a 97% reduction in the risk of CHD death (NNT 15) with the addition of lifestyle changes. A secondary prevention polyportfolio holds great promise for reducing the burden of cardiovascular disease in the highest risk patients.

Life Style

Diet, Mediterranean

Cardiovascular Diseases - prevention & control

Humans

Risk Factors

Calcium Channel Blockers - therapeutic use

Exercise

Angiotensin-Converting Enzyme Inhibitors - therapeutic use

Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use

Fatty Acids, Omega-3 - therapeutic use

Diuretics - therapeutic use

Aspirin - therapeutic use

Drug Therapy, Combination

Adrenergic beta-Antagonists - therapeutic use

Details

Title: Subtitle: A "poly-portfolio" for secondary prevention: a strategy to reduce subsequent events by up to 97% over five years
Creators: Jennifer G Robinson - Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA. jennifer-g-robinson@uiowa.edu
Nidhi Maheshwari
Resource Type: Journal article
Publication Details: The American journal of cardiology, Vol.95(3), pp.373-378
Publisher: United States
DOI: 10.1016/j.amjcard.2004.09.036
PMID: 15670547
ISSN: 0002-9149
eISSN: 1879-1913
Language: English
Date published: 02/01/2005
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983996095002771

Metrics

31 Record Views

39 Times Cited - Web of Science