Is there a need for a polypill in secondary prevention?
Polypharmacy is already widely used in secondary prevention, as effective and safe interventions to reduce the risk for recurrent events have been identified in people with established CVD. Such secondary prevention measures include in addition to lifestyle, pharmacological therapies proven to reduce the risk of recurrent events and mortality, namely, aspirin, statins, β-blockers and ACE inhibitors. The dramatic decline in cardiovascular mortality achieved in developed countries during the last decades underlines the importance of secondary prevention measures and it is estimated that approximately half of the observed reduction in cardiovascular mortality could be attributable to medical therapy [23]. However, several problems hamper the use of medication for CVD in secondary prevention. Thus, proven therapies are not prescribed in all those who may derive benefit and a substantial treatment gap has been identified in surveys undertaken in various countries. For example, the European
