About this trial
The Polypill Approach for Multiple Cardiovascular Risk Factors (PACIF) trial is a multicenter randomized controlled trial that will test the effectiveness and safety of a fixed-dose combination strategy for integrated management of hypertension, dyslipidemia, and diabetes among adults aged 50 to 75 years in China. The trial will evaluate whether a simplified regimen combining blood pressure-lowering, lipid-lowering, and glucose-lowering therapy improves the 10-year cardiovascular disease risk score at phase 1. Participants will be followed to determine whether the fixed-dose combination strategy reduces major cardiovascular events and cognitive function compared with usual care at phase 2.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Men or women
Age ≥50 years and <75 years
Hypertension, defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg among participants not currently taking antihypertensive medication, or systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg among participants currently taking any antihypertensive medication
Dyslipidemia, defined as LDL-C ≥1.8 mmol/L (70 mg/dL)
Disqualifiers
Known secondary cause of hypertension
Type 1 diabetes
Pancreatic insufficiency or diabetes secondary to pancreatitis
Triglycerides ≥5.65 mmol/L (500 mg/dL)
Trial design
Parallel
Treatments tested in this trial
Fixed-Dose Combination Strategy
DrugParticipants assigned to the intervention group will receive a fixed-dose combination strategy for integrated control of blood pressure, lipid, and glucose. Six predefined medication regimens will be used, differing in antihypertensive intensity and rosuvastatin dose. The antihypertensive component will consist of olmesartan medoxomil/amlodipine at 10/2.5 mg or 20/5 mg, with indapamide 2.5 mg added if needed, and will be titrated toward a blood pressure target of \<130/80 mm Hg according to prespecified protocol rules. The lipid-lowering component will be initiated with rosuvastatin 10 mg plus ezetimibe 10 mg. If suspected statin-associated adverse effects or statin intolerance occur, the rosuvastatin dose may be reduced from 10 mg to 5 mg according to prespecified protocol rules. The glucose-lowering component will consist of dapagliflozin at a fixed dose of 10 mg. Treatment will be selected and adjusted according to treatment targets, tolerability, and safety.
Treatment groups
Trial outcomes
Primary outcomes
10-year CVD risk
Changes in 10-year CVD risk estimated by the PREVENT equations
Composite cardiovascular disease outcome
Record the occurrence of newly diagnosed composite cardiovascular disease
Secondary outcomes
Major secondary endpoint: All-cause dementia
Record all-cause dementia
10-year ASCVD risk
Changes in 10-year ASCVD risk estimated by the PREVENT equations
10-year HF risk
Changes in 10-year HF risk estimated by the PREVENT equations
The proportion of patients achieved blood pressure target
The proportion of patients achieved blood pressure target (systolic blood pressure \<130 mmHg and diastolic blood pressure \<80 mmHg)
Sponsors and contacts
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China Medical University, China
Lead sponsor
First Hospital of China Medical University
Sponsor institution
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