Medication adherence remains an important challenge in long-term cardiovascular risk management. A randomized study presented at ESH Congress 2026 evaluated the association  between treatment adherence and left ventricular myocardial mass (LVMM) in patients receiving either a fixed-dose combination polypill or separate antihypertensive and lipid-lowering therapy. 

The study included 120 patients with arterial hypertension and dyslipidemia at high or very high cardiovascular risk (mean SCORE2 risk, 18.1 ± 7.8). Patients were randomized to receive either a fixed-dose combination of lisinopril, amlodipine, and rosuvastatin or separate administration of perindopril/amlodipine and rosuvastatin. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), while LVMM was measured by transthoracic echocardiography over 6 months of follow-up. 

Findings

In the polypill group, higher MMAS-8 adherence scores were associated with greater regression of LVMM(rs=-0.5768; p=0.001).
No significant association between adherence and LVMM was observed in patients receiving separate therapy (rs=-0.0452; p=0.74).
Greater adherence-related reverse left ventricular remodeling was observed with fixed-dose polypill therapy than with separate treatment administration. 

The findings suggest that higher adherence to fixed-dose combination therapy may be associated with greater regression of left ventricular myocardial mass in patients with hypertension and dyslipidemia at elevated cardiovascular risk.