Fixed-dose combination therapy may simplify treatment regimens for patients requiring multiple cardiovascular medications, although its relationship with adherence-associated cardiovascular risk reduction remains under evaluation. A randomized study presented at the ESH 2026 assessed the association between medication adherence and estimated cardiovascular risk among patients with arterial hypertension and dyslipidemia at high or very high cardiovascular risk. 

Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), while cardiovascular risk was estimated using the SCORE2 model. Participants were randomized to receive either a fixed-dose polypill containing lisinopril, amlodipine, and rosuvastatin (n=60) or a free combination regimen consisting of perindopril, amlodipine, and rosuvastatin administered separately (n=59). Outcomes were evaluated after 6 months of treatment. The study enrolled 119 patients with arterial hypertension and dyslipidemia at high or very high cardiovascular risk.

Findings

• After 6 months, the fixed-dose polypill group demonstrated a strong inverse correlation between MMAS-8 scores and SCORE2-estimated cardiovascular risk (Spearman rs = –0.83266; p<0.001).
• Higher medication adherence in the polypill group was associated with lower estimated cardiovascular risk.
• No significant association between MMAS-8 scores and SCORE2 cardiovascular risk was observed in the free combination therapy group (Spearman rs = –0.06146; p=0.65272).
• The fixed-dose strategy demonstrated a stronger association between medication adherence and estimated cardiovascular risk than separate medication administration.

The findings suggest that fixed-dose polypill therapy may support adherence-associated reductions in SCORE2-estimated cardiovascular risk among high-risk patients with hypertension and dyslipidemia.