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Starting the polypill: the use of a single age cut-off in males and females.

Wald, NJ; Luteijn, JM; Morris, JK (2017) Starting the polypill: the use of a single age cut-off in males and females. J Med Screen, 24 (1). pp. 50-53. ISSN 1475-5793 https://doi.org/10.1177/0969141316631578
SGUL Authors: Morris, Joan Katherine

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Abstract

Objective Age screening and preventive medication for future myocardial infarction and stroke has been previously described. We aimed to ascertain whether different age cut-offs are needed for males and females. Methods We determined five parameters for each sex according to age cut-off: detection rate (sensitivity), false-positive rate, proportion of the population eligible for treatment with a polypill, proportion who benefit from taking a polypill (simvastatin 20 mg, losartan 25 mg, hydrochlorothiazide 12.5 mg, amlodipine 2.5 mg), and among these, years of life gained without a first myocardial infarction or stroke. Results Approximately one-third benefit, regardless of the age cut-off. For males and females combined, using ages 40 and 80, the detection rates are 98% and 52%, false-positive rates are 51% and 7%, population percentages eligible for treatment are 52% and 7%, and years of life gained without a first myocardial infarction or stroke are 8.4 and 3.6. Using age 50, detection rates are 93% (males) 98% (females), false-positive rates 37% (males) 40% (females), percentage of the population eligible for treatment 38% (males) 41% (females), percentage who benefit 35% (males) 33% (females), and years of life gained without an event 8.5 (males) 7.0 (females). At a given age cut-off, the sex differences are relatively small. Conclusion A single age cut-off can be used for both sexes.

Item Type: Article
Additional Information: © The Author(s) 2016. Creative Commons License (CC BY-NC 3.0) This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Request permissions for this article.
Keywords: Polypill, cardiovascular disease, myocardial infarction, screening, stroke, Adult, Age Factors, Aged, Cardiovascular Agents, Drug Combinations, Female, Humans, Hydrochlorothiazide, Losartan, Male, Middle Aged, Myocardial Infarction, Preventive Health Services, Simvastatin, State Medicine, Stroke, United Kingdom, Humans, Myocardial Infarction, Losartan, Hydrochlorothiazide, Simvastatin, Cardiovascular Agents, Drug Combinations, Age Factors, Adult, Aged, Middle Aged, Preventive Health Services, State Medicine, Female, Male, Stroke, United Kingdom, Polypill, screening, cardiovascular disease, stroke, myocardial infarction, 1117 Public Health and Health Services, Public Health
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Academic Structure > REF 2021 user group
Journal or Publication Title: J Med Screen
ISSN: 1475-5793
Language: eng
Dates:
DateEvent
March 2017Published
11 April 2016Published Online
15 January 2016Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 3.0
PubMed ID: 27072544
Web of Science ID: WOS:000394754200008
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/116642
Publisher's version: https://doi.org/10.1177/0969141316631578

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