Washington: A fixed-dose combination medication for BP, cholesterol, and platelet control may significantly improve medication adherence after 15 months and small improvements in systolic blood pressure and low-density lipoprotein cholesterol.
The randomized trial included about 2,000 patients with or at high risk of cardiovascular disease (CVD).
Simon Thom, M.B., B.S., M.D., of the International Centre for Circulatory Health, Imperial College London, and colleagues conducted a study to assess whether FDC delivery of aspirin, statin, and 2 blood pressure-lowering agents vs. usual care improves long-term adherence to indicated therapy and 2 major CVD risk factors, systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C).
Participants were randomly assigned (1:1) to an FDC-based strategy (n=1,002) containing either (1) 75 mg aspirin, 40 mg simvastatin, 10 mg lisinopril, and 50 mg atenolol or (2) 75 mg aspirin, 40 mg simvastatin, 10 mg lisinopril, and 12.5 mg hydrochlorothiazide or to usual care (n=1,002).
At baseline, average BP was 137/78 mm Hg, LDL-C was 91.5 mg/dL, and 1,233 (61.5 percent) of 2,004 participants reported use of antiplatelet, statin, and 2 or more BP-lowering medications. The median (midpoint) duration of follow-up was 15 months for both groups.
At the end of the study, 829 (86.3 percent) of 961 participants in the FDC group were continuing with indicated medications compared with 621 (64.7 percent) of 960 in the usual care group. In absolute terms, this amounted to a 21.6 percent difference in treatment rates.
Overall, SBP (-2.6 mm Hg) and LDL-C (-4.2 mg/dL) levels were modest but significantly lower in the FDC group compared with the usual care group at the end of the study.
The study has been published in JAMA.