Comparative Analysis of the Efficacy of a Polypill and a Free Combination of Antihypertensive Drugs and Statins in the Context of an Individualized Treatment Strategy

ORIGINAL ARTICLE
Shakhlo S. Fayzullaeva, Gulnoz A. Khamidullaeva, Guzal Zh. Abdullaeva, Khafiza F. Yusupova, Saida A. Ikramova

 
For citation: Fayzullayeva SS, Khamidullayeva GA, Abdullayeva GJ, Yusupova KF, Ikramova SA. Comparative Analysis of the Efficacy of a Polypill and a Free Combination of Antihypertensive Drugs and Statins in the Context of an Individualized Treatment Strategy. International Journal of Biomedicine. 2025;15(3):461-468. doi:10.21103/Article15(3)_OA1
 
Originally published September 5, 2025

Abstract: 

The objective of this study was to compare the effectiveness of a 6-month course of therapy using a fixed-dose combination (polypill) and a free combination of antihypertensive drugs and statins in achieving target levels of blood pressure (BP) and lipid profile in hypertensive patients with high and very high cardiovascular risk. 
Methods and Results: The study included 92 patients with arterial hypertension (AH) Grades 1-3 (ESC/ESH, 2018), aged 40 to 75 years, of both sexes. The mean age of patients was 53.6±9.6 years; the average duration of AH was 9.2±7.1 years.
All patients underwent general clinical examination, the 24-hour ambulatory blood pressure monitoring (ABPM), biochemical blood tests, ECG, standard transthoracic two-dimensional echocardiography, and the carotid intima-media thickness (CIMT) of the common carotid artery assessment by duplex scanning. Arterial stiffness was determined using applanation tonometry.
All patients included in the study were randomly divided into two groups. Group 1 (n=46) received an FDC combination or "polypill" combining lisinopril/amlodipine/rosuvastatin in a single tablet. Group 2 (n=46) received the combination of perindopril/amlodipine and rosuvastatin in separate forms. The drugs were prescribed in therapeutic doses: perindopril (4–8 mg/day), lisinopril (10–20 mg/day), amlodipine (5–10 mg/day), and rosuvastatin (initial dose 10 mg/day). The final treatment results were determined after 6-month therapy.
Two ACEI/CCB/statin therapy regimens, including polypill combining lisinopril, amlodipine, rosuvastatin, and a free combination of perindopril, amlodipine, and rosuvastatin, demonstrated high antihypertensive, lipid-lowering efficacy, and metabolic neutrality in high-risk AH patients. Both treatment regimens allowed many patients to achieve the target BP; however, in Group 1, the number of patients who achieved target BP levels was greater than in Group 2. In addition to achieving target BP levels, a significant reduction in vascular stiffness was observed in Group 1. Group 1 showed high lipid-lowering efficacy. It was also found that the SCORE2 score decreased significantly in Group 1, reaching the normal range. At the same time, both treatment regimens showed high antihypertensive and organoprotective efficacy.
Conclusion: The polypill therapy demonstrated superiority over the separate regimen, resulting in a greater reduction in BP and an improvement in lipid profile. These results highlight the importance of choosing the right treatment regimen for patients with high cardiovascular risk and indicate the efficacy of polypills in this patient group.

Keywords: 
arterial hypertension • cardiovascular risk • angiotensin-converting enzyme inhibitor • calcium channel blocker • statins
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Received June 21, 2025.
Accepted August 8, 2025.
©2025 International Medical Research and Development Corporation.