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Fixed-dose combination treatment after stroke for secondary prevention in China: a national community-based study
Wang Longde1, Yin Ling1, Hua Yang1
1From the School of Public Health, Peking University, Beijing, China (W.L.); Center of Remote Medicine, Army General Hospital, Beijing, China (Y.L., L.M.); Department of Ultrasound (H.Y.), Xuanwu Hospital (J.X.), and Tiantan Hospital (W.Y.), Capital Medical University, Beijing, China; Health and Family Planning Commission of Shandong Province, Jinan, China (Z.Y.); Department of Neurology, The First Affiliated Hospital of Shanxi Medical University,Taiyuan, China (N.X.); Department of Neurology, The First Affiliated Hospital of Medical School of Xian Jiaotong University, Xian, China (Q.Q.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (H.L.); Department of Neurology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China (X.Y.); and Department of Epidemiology, Beijing An Zhen hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China (S.J., L.J., Z.D.).
Background And Purpose:
There is evidence and international consensus on the advantages and potential of a polypill for established cardiovascular disease patients to improve adherence in the secondary prevention of cardiovascular disease. This study aimed to estimate the numbers of stroke patients who would be eligible for the polypill strategy in China, and the suitable composition of a polypill, based on data of the China National Stroke Prevention Project.
Methods:
A total of 717 620 residents aged ≥40 years from 6 Chinese representative provinces were screened for prevalent stroke from 2011 to 2012 with an 84.4% response rate. Participants with a history of stroke received further investigation of risk factors and treatments. The potential need for treatment was classified according to the guidelines. Rates were standardized using the population composition of the Sixth National Population Census of China.
Results:
The standardized prevalence rate of stroke was 1.9%. Up to 93.1% of stroke patients were eligible for a polypill containing at least 2 types of medications, with 75.3% eligible for a statin and antiplatelet agent and 70.6% for antihypertensive and antiplatelet medications. Considering 3 therapies, 54% were eligible for antihypertensive, statin, and antiplatelet medications. The current treatment rate with all required combinations of separate pills was only 6.9%.
Conclusions:
A huge number of stroke patients in China require preventive therapy and would be eligible for a polypill. This study indicates that it would be reasonable to consider and assess the value of a polypill strategy to improve secondary prevention of stroke in China.
