使用混合藥物Polypill作為心血管疾病的預防策略之評估

Evaluation of the Effectiveness of a "Polypil" as a Strategy for the Prevention of Cardiovascular Disease

莊筱婷(Hsiao-Ting Juang) ； 簡國龍(Kuo-Liong Chien)

《台灣公共衛生雜誌》 31卷3期 (2012/06) Pp. 217-227

https://doi.org/10.6288/TJPH2012-31-03-02

摘要

雖然利用生活習慣的改變是防治心血管疾病的基石，但是大多數人無法長期有效地持續進行行為矯正，來維持促進心血管健康。因此，利用包含aspirin、降血壓及降血脂藥物的混合藥劑“Polypill”來預防心血管疾病成為一個值得注意的預防策略。目前關於Polypill的藥效及不良反應之臨床試驗結果顯示出，Polypill是預防心血管疾病的良好策略，並且在醫師及病人對於使用Polypill的態度也顯示有一定可行性。然而，對於Polypill藥物中的組成成分、劑量及藥物的效果和安全性仍需更多的研究來評估，而且也需要進一步地研究Polypill是否能降低心血管疾病發病率及在發展中國家的成本效益分析。

關鍵字

藥物 ； Polypill ； 心血管疾病的預防

並列摘要

The prevention of cardiovascular disease (CVD) is an important component of health promotion. Although behavioral lifestyle change is considered to be the first priority and the basis for several management modalities, many individuals cannot continue behavioral modification effectively for a long period of time. Therefore, a combination of multiple generic drugs, including aspirin, and blood pressure and cholesterol-lowering medications, becomes an appealing approach to CVD prevention. ”Polypill” is a single pill combining several drugs that could reduce cardiovascular risk. Evidence from the results of randomized clinical trials for the efficacy and adverse effects of ”Polypill” have recently become available. The data showed that ”Polypill” may be a good strategy for the prevention of CVD, and the acceptance of ”Polypill” by some primary care physicians and patients appears to be moderate to high; however, additional studies and more systematic evaluations of the optimal component drug dosage, combination formulae, and the efficacy and safety of the ”Polypill” are needed. Further studies are also warranted in order to determine if the ”Polypill” can reduce the incidence of CVD and is cost-effectiveness for developing countries.

並列關鍵字

drugs ； Polypill ； cardiovascular disease prevention

參考文獻

行政院衛生署：民國99年死因結果摘要表。http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=81294&s=1。引用2011/11/20。Department of Health, Executive Yuan, R.O.C.(Taiwan). The summary of cause of death statistics in 2010. Available at:http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=81294&s=1. Accessed November 20, 2011. [In Chinese]

行政院衛生署：98年度單方藥品健保申報排行。http://www.doh.gov.tw/CHT2006/other/ShowCopy.aspx?doc_no=74802&class_no=25。引用2011/11/20。Department of Health, Executive Yuan, R.O.C.(Taiwan). Rank of single-ingredient drugs by claims to National Health Insurance, 2009. Available at: http://www.doh.gov.tw/CHT2006/other/ShowCopy.aspx?doc_no=74802&class_no=25. Accessed November 20,2011. [In Chinese]

Clinicaltrials.gov. Basic search. Available at: http://clinicaltrials.gov/ct2/search. Accessed November 20, 2011.

ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group(2002).Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).JAMA.288,2981-97.

Avorn, J.,Monette, J.,Lacour, A.(1998).Persistence of use of lipid-lowering medications - a cross-national study.JAMA.279,1458-62.