Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Fixed-Dose Combo Therapy for Prevention of ASCVD

Cochrane Database; ePub 2017 Mar 6; Bahiru, et al

The effects of fixed-dose combination therapy on all-cause mortality and fatal and nonfatal heart attacks and strokes are uncertain; however, modest increases in adverse events were observed when compared to placebo. This according to an updated review that included 4 studies (n=2,102 participants, mean age range 62-63 years) with individuals with a prior heart attack or stroke or with a high predicted risk for having an initial heart attack and 5 studies that had long-term follow-up (≥12 months). Most participants were middle-aged men with moderate elevations in blood pressure (BP) or cholesterol. The fixed-dose combinations ranged from 2 to 5 drugs; all studies included at least 1 BP-lowering and 1 cholesterol-lowering drug. Researchers found:

  • The effects of fixed-dose combination drug therapy on all-cause mortality and fatal and nonfatal heart attacks and strokes are uncertain.
  • Fixed-dose combination drug therapy leads to more adverse events than control (32% vs 27%), including placebo.
  • Fixed-dose combination therapy may modestly lower BP and cholesterol and appears to improve adherence to medications to prevent ASCVD.


Bahiru E, de Cates AN, Farr MRB, et al. Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.:CD009868. doi:10.1002/14651858.CD009868.pub3.

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