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Global impact of fixed-dose combination therapies on cardiovascular mortality and events, 2023-2050: a modeling study

2025Journal article Restricted access
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dc.contributor.authorWatkins, David A.
dc.contributor.authorPickersgill, Sarah
dc.contributor.authorFlood, David
dc.contributor.authorGaziano, Thomas A.
dc.contributor.authorHuffman, Mark D.
dc.contributor.authorIslam, Shofiqul
dc.contributor.authorJoseph, Philip
dc.contributor.authorPerel, Pablo
dc.contributor.authorPiñeiro, Daniel J.
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorYusuf, Salim
dc.date.accessioned2025-07-30T10:33:02Z
dc.date.available2025-07-30T10:33:02Z
dc.date.issued2025
dc.description© 2025 by the American College of Cardiology Foundation. Published by Elsevier.pt_PT
dc.description.abstractBackground: Uptake of drugs for primary and secondary prevention of cardiovascular disease is low in many countries. Single-pill combination (SPC) therapies consisting of a statin and 1 or more antihypertensive drugs, with or without aspirin, can reduce rates of fatal and nonfatal cardiovascular disease, but their use is currently limited. Objectives: The authors modeled the potential impact of widespread adoption of SPC therapies over 2023 to 2050. Methods: We used state-transition and demographic modeling approaches to project ischemic heart disease- and stroke-related deaths and nonfatal events in 182 countries. We modeled the effects of programs to roll out primary and secondary prevention SPCs in 2 scenarios, compared to non-SPC (current) care: 1) targeted strategies to improve adherence and reduce therapeutic inertia among persons already in care; and 2) population-based strategies to provide SPC therapies to most persons at intermediate-to-high risk. We conducted sensitivity analyses around our assumptions on adoption, long-term adherence, and the effect of aspirin. Results: Over 2023-2050, use of SPC therapies could prevent up to 29 million deaths and 51 million cases in the targeted scenario and up to 72 million deaths and 130 million cases in the population scenario. The greatest share of fatal and nonfatal events prevented would be in South and East Asia and the Pacific because of population size. SPC therapies could reduce all-cause premature mortality by 2.0% (targeted) to 3.2% (population), facilitating achievement of global health targets. Conclusions: SPC therapies could substantially accelerate progress on cardiovascular disease mortality by increasing use of preventive drugs, especially in settings where uptake is currently low.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Am Coll Cardiol. 2025 Jul 22;86(3):149-161pt_PT
dc.identifier.doi10.1016/j.jacc.2025.04.043pt_PT
dc.identifier.eissn1558-3597
dc.identifier.issn0735-1097
dc.identifier.urihttp://hdl.handle.net/10400.5/102531
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/journal-of-the-american-college-of-cardiologypt_PT
dc.subjectCardiovascular diseasespt_PT
dc.subjectGlobal healthpt_PT
dc.subjectImplementation sciencept_PT
dc.subjectMortalitypt_PT
dc.subjectSingle-pill combinationpt_PT
dc.titleGlobal impact of fixed-dose combination therapies on cardiovascular mortality and events, 2023-2050: a modeling studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage161pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage149pt_PT
oaire.citation.titleJournal of the American College of Cardiologypt_PT
oaire.citation.volume86pt_PT
person.familyNamePinto
person.givenNameFausto J.
person.identifier1308889
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-8034-4529
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id7102740158
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublication.latestForDiscovery5f44176f-69f5-482c-83cd-ab94425a6ec3

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