Reorganizing the treatment of cardiovascular disease in response to coronavirus disease 2019; time for the polypill?
Identifieur interne : 000289 ( Main/Corpus ); précédent : 000288; suivant : 000290Reorganizing the treatment of cardiovascular disease in response to coronavirus disease 2019; time for the polypill?
Auteurs : Christopher N. Floyd ; Anthony S. WierzbickiSource :
- Current opinion in cardiology [ 1531-7080 ] ; 2020.
English descriptors
- KwdEn :
- Antihypertensive Agents (administration & dosage), Betacoronavirus (MeSH), Cardiovascular Diseases (complications), Cardiovascular Diseases (drug therapy), Coronavirus (MeSH), Coronavirus Infections (epidemiology), Delivery of Health Care (MeSH), Drug Combinations (MeSH), Humans (MeSH), Pandemics (MeSH), Platelet Aggregation Inhibitors (administration & dosage), Pneumonia, Viral (epidemiology).
- MESH :
- chemical , administration & dosage : Antihypertensive Agents, Platelet Aggregation Inhibitors.
- complications : Cardiovascular Diseases.
- drug therapy : Cardiovascular Diseases.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- Betacoronavirus, Coronavirus, Delivery of Health Care, Drug Combinations, Humans, Pandemics.
Abstract
PURPOSE OF REVIEW
The coronavirus disease 2019 (COVID-19) pandemic has forced a redesign of healthcare services. Resource reallocation will have consequences on the routine management of chronic diseases, including cardiovascular disease (CVD). We consider how to mitigate potential adverse effects.
RECENT FINDINGS
Combination therapy is well established in hypertension. Many guidelines recommend dual antihypertensive therapy as the initial treatment step as this results in faster blood pressure control, albeit with limited evidence of improved outcomes. Control of CVD risk factors through multiclass combination therapy (the polypill) was proposed many years ago. This approach has not been adopted by Western healthcare systems despite improving surrogate outcomes. Recently, the PolyIran trials have demonstrated improved CVD outcomes without increased adverse events, in both primary and secondary prevention.
SUMMARY
The COVID-19 pandemic allows models of chronic healthcare to be rethought. Current practices are resource-intensive and there is a need to simplify titration and monitoring protocols in CVD. Moving toward the use of polypill combinations allied with telehealth consultations may be one solution.
DOI: 10.1097/HCO.0000000000000759
PubMed: 32398607
Links to Exploration step
pubmed:32398607Le document en format XML
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Wierzbicki</name><affiliation><nlm:affiliation>Department Clinical Pharmacology.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32398607</idno><idno type="pmid">32398607</idno><idno type="doi">10.1097/HCO.0000000000000759</idno><idno type="wicri:Area/Main/Corpus">000289</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000289</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Reorganizing the treatment of cardiovascular disease in response to coronavirus disease 2019; time for the polypill?</title><author><name sortKey="Floyd, Christopher N" sort="Floyd, Christopher N" uniqKey="Floyd C" first="Christopher N" last="Floyd">Christopher N. Floyd</name><affiliation><nlm:affiliation>Department Clinical Pharmacology.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department Chemical Pathology, Guy's and St. Thomas' NHS Foundation Trust.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department Clinical Pharmacology, King's College London, British Heart Foundation Centre, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Wierzbicki, Anthony S" sort="Wierzbicki, Anthony S" uniqKey="Wierzbicki A" first="Anthony S" last="Wierzbicki">Anthony S. Wierzbicki</name><affiliation><nlm:affiliation>Department Clinical Pharmacology.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Current opinion in cardiology</title><idno type="eISSN">1531-7080</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antihypertensive Agents (administration & dosage)</term><term>Betacoronavirus (MeSH)</term><term>Cardiovascular Diseases (complications)</term><term>Cardiovascular Diseases (drug therapy)</term><term>Coronavirus (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Delivery of Health Care (MeSH)</term><term>Drug Combinations (MeSH)</term><term>Humans (MeSH)</term><term>Pandemics (MeSH)</term><term>Platelet Aggregation Inhibitors (administration & dosage)</term><term>Pneumonia, Viral (epidemiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antihypertensive Agents</term><term>Platelet Aggregation Inhibitors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>Coronavirus</term><term>Delivery of Health Care</term><term>Drug Combinations</term><term>Humans</term><term>Pandemics</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE OF REVIEW</b></p><p>The coronavirus disease 2019 (COVID-19) pandemic has forced a redesign of healthcare services. Resource reallocation will have consequences on the routine management of chronic diseases, including cardiovascular disease (CVD). We consider how to mitigate potential adverse effects.</p></div><div type="abstract" xml:lang="en"><p><b>RECENT FINDINGS</b></p><p>Combination therapy is well established in hypertension. Many guidelines recommend dual antihypertensive therapy as the initial treatment step as this results in faster blood pressure control, albeit with limited evidence of improved outcomes. Control of CVD risk factors through multiclass combination therapy (the polypill) was proposed many years ago. This approach has not been adopted by Western healthcare systems despite improving surrogate outcomes. Recently, the PolyIran trials have demonstrated improved CVD outcomes without increased adverse events, in both primary and secondary prevention.</p></div><div type="abstract" xml:lang="en"><p><b>SUMMARY</b></p><p>The COVID-19 pandemic allows models of chronic healthcare to be rethought. Current practices are resource-intensive and there is a need to simplify titration and monitoring protocols in CVD. Moving toward the use of polypill combinations allied with telehealth consultations may be one solution.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32398607</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>09</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>09</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-7080</ISSN><JournalIssue CitedMedium="Internet"><Volume>35</Volume><Issue>4</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>Current opinion in cardiology</Title><ISOAbbreviation>Curr. Opin. Cardiol.</ISOAbbreviation></Journal><ArticleTitle>Reorganizing the treatment of cardiovascular disease in response to coronavirus disease 2019; time for the polypill?</ArticleTitle><Pagination><MedlinePgn>428-433</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/HCO.0000000000000759</ELocationID><Abstract><AbstractText Label="PURPOSE OF REVIEW">The coronavirus disease 2019 (COVID-19) pandemic has forced a redesign of healthcare services. Resource reallocation will have consequences on the routine management of chronic diseases, including cardiovascular disease (CVD). We consider how to mitigate potential adverse effects.</AbstractText><AbstractText Label="RECENT FINDINGS">Combination therapy is well established in hypertension. Many guidelines recommend dual antihypertensive therapy as the initial treatment step as this results in faster blood pressure control, albeit with limited evidence of improved outcomes. Control of CVD risk factors through multiclass combination therapy (the polypill) was proposed many years ago. This approach has not been adopted by Western healthcare systems despite improving surrogate outcomes. Recently, the PolyIran trials have demonstrated improved CVD outcomes without increased adverse events, in both primary and secondary prevention.</AbstractText><AbstractText Label="SUMMARY">The COVID-19 pandemic allows models of chronic healthcare to be rethought. Current practices are resource-intensive and there is a need to simplify titration and monitoring protocols in CVD. 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