Evidence mapPaperPMID 36689592Full record

ReviewStroke2023

Polypill Programs to Prevent Stroke and Cut Costs in Low Income Countries: Moving From Clinical Efficacy to Pragmatic Implementation.

Fred Stephen Sarfo, Michelle Nichols, Priscilla Abrafi Opare-Addo, Bruce Ovbiagele

Open access · bronzeAbstract readReview
In one paragraph

Review in Stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 18 citations in OpenAlex.

  1. Trial
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  12. Epigenetics as a target to mitigate excess stroke risk in people of African ancestry: A scoping review.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2024
    Article
  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Fred Stephen SarfoDepartment of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana (F.S.S.).ORCID 0000-0001-7274-5093
Michelle NicholsDepartment of Nursing, Medical University of South Carolina, Charleston (M.N.).ORCID 0000-0002-2078-9649
Priscilla Abrafi Opare-AddoDepartment of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S.S., P.A.O.-A.).ORCID 0000-0002-2194-775X
Bruce OvbiageleDepartment of Neurology, University of California, San Francisco (B.O.).ORCID 0000-0002-9958-0644
Komfo Anokye Teaching Hospital · GHMedical University of South Carolina · USUniversity of California, San Francisco · US

Funding

Stroke Minimization through Additive Anti-atherosclerotic Agents in Routine Treatment II StudyR01NS129133 · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · 2025 to 2025
$511k
Ghana-SPARCO: Ghana Sickle Pan-African Research ConsortiumU01HL157004 · KWAME NKRUMAH UNIVERSITY/SCIENCE/TECH · 2025 to 2025
$350k
NHLBI NIH HHS R01 HL152188NHLBI NIH HHS U01 HL157004NINDS NIH HHS R01 NS129133NINDS NIH HHS R21 NS103752
6 · The paper itself

Abstract

Current projections are that the already overwhelming burden of strokes and atherosclerotic cardiovascular diseases in low- and middle-income countries (LMICs) will continue to rise over the coming decades as the prevalence of traditional vascular risk factors burgeon in these countries. Cardiovascular polypills containing combinations of antihypertensive(s), a statin, with or without aspirin or folic acid in the form of a single pill, represent a viable strategy for both primary and secondary prevention of atherosclerotic cardiovascular diseases in LMICs. Large multicenter trials in LMIC and high-income country (HIC) settings have now clearly demonstrated the beneficial effects of the cardiovascular polypill versus placebo (or usual care) in reducing primary stroke risk by 50%. For survivors of a recent myocardial infarction residing in HICs, the polypill reduced risk of major cardiovascular events by 25% due to improved treatment adherence. Data on the clinical efficacy of the polypill for secondary stroke prevention are scanty both in HICs and LMICs. Cost-effectiveness analyses data from LMICs suggest cost savings with the polypill for primary and secondary prevention of stroke and atherosclerotic cardiovascular diseases. However, major contextual barriers in LMICs need to be surmounted through mixed methods research and hybrid clinical trials to assess its real-world effectiveness, before the adoption of the polypill for primary and secondary atherosclerotic cardiovascular disease prevention in routine clinical practice.

Indexed as

AtherosclerosisCardiovascular DiseasesHydroxymethylglutaryl-CoA Reductase InhibitorsStrokeAntihypertensive AgentsDeveloping CountriesDrug CombinationsHumansPlatelet Aggregation InhibitorsTreatment OutcomeAntihypertensive AgentsDrug CombinationsHydroxymethylglutaryl-CoA Reductase InhibitorsPlatelet Aggregation Inhibitorsdyslipidemiahypertensionprimary preventionsecondary preventionstroke

Identifiers

PMID36689592
PMCPMC9909591
OpenAlexW4317868689

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.