Polypill Strategy Shows Significant Benefits for Heart Failure Patients in Underserved Populations

Patients with heart failure and reduced ejection fraction who took a single combination pill containing three heart failure medications showed significant improvements in heart function, fewer hospitalizations, and better quality of life compared to those taking the same medications as separate pills, according to research presented at the American Heart Association's Scientific Sessions 2025. The study, which focused on socially disadvantaged populations, represents the first evaluation of a polypill strategy specifically for heart failure with reduced ejection fraction (HFrEF). The trial included 212 adults with HFrEF who were not receiving guideline-recommended treatment.

Participants were randomly assigned to either a polypill regimen containing metoprolol succinate, spironolactone and empagliflozin, or to enhanced standard care taking the same medications as individual pills. All participants also took sacubitril-valsartan, which is dosed twice daily and not suitable for inclusion in the once-daily polypill. After six months, the results showed substantial benefits for the polypill group. Patients taking the combination medication had a 3.4% higher absolute left ventricular ejection fraction, indicating improved heart function. More dramatically, the polypill reduced heart failure-related hospitalizations and emergency room visits by 60%, meaning patients in this group were less than half as likely to need emergency care.

Quality of life measures also favored the polypill approach. Patients reported scores approximately 9 points higher on the Kansas City Cardiomyopathy Questionnaire-12, indicating less fatigue, fewer symptoms and better overall well-being. Medication adherence proved significantly better in the polypill group, with blood tests showing 79% of these patients had detectable levels of the tested medications compared to only 54% in the standard care group. Study author Ambarish Pandey, M.D., M.S., FAHA, from UT Southwestern Medical Center, noted that despite important treatment advances in recent decades, only about 15% of patients receive all guideline-recommended therapies for heart failure after hospitalization.

The study population reflected this challenge, with 68% of participants having no health insurance or receiving county-sponsored coverage, 42% reporting food insecurity, and 32% reporting housing instability. The research team plans additional studies to evaluate broader implementation of the polypill approach in heart failure. The findings are particularly relevant given the rising prevalence of heart failure in the United States, where about 6.7 million adults currently live with the condition, projected to increase to more than 8 million by 2030 according to American Heart Association statistics available at https://www.heart.org. The study abstract can be viewed in the American Heart Association Scientific Sessions 2025 Online Program Planner.

It is important to note that the study findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. The research was conducted at multiple Dallas-area institutions including Parkland Health and Hospital System, UT Southwestern Medical Center and William F. Clements University Hospital over approximately 3.5 years, with enrollment concluding in May 2025.