Can Use of Multiple Medications Improve Clinical Adaptations and decrease the Risk of Cardiovascular Diseases?


Authors: Jan Fedacko, Viola Vargova, Viliam Mojto, Fatemeh Nabavizadeh, Oleg Medvedev, Nikolay Tselov, and Vijay Agarwal
Page Range: 13-17
Published in: World Heart Journal, 15#1 (2023)
ISSN: 1556-4002

Table of Contents


The integrity of the myocardium is maintained on the premise that death of the cardiomyocyte and its regeneration are part of the normal homeostasis of the heart for molecular adaptation. In the presence of diseases or risk factors or in the course of normal aging, the balance in the cardiomyocyte death and regeneration is altered and cardiomyocyte formation is overtaken by apoptosis or cell death [1, 2]. The decline in the number of ventricular cardiomyocytes inculcates the hypertrophy of the existing cardiomyocyte as a result of human molecular adaptation. However, due to the lower molecular capability of adaptation with time and increase in cardiomyocyte death, it leads to pathological remodelling, resulting in chronic heart failure, in an attempt to pump adequate blood to the brain for neuronal survival. The conversion from physiological remodelling to pathological remodelling also depends on the presence of protective factors such as a Mediterranean-style diet and exercise training, which are known to provide further protection and may increase the survival of cardiomyocytes [1]. However, a Western-type diet rich in sweetened products, tobacco and alcohol use are known to decrease the molecular capability of cardiomyocytes, resulting in cardio-myocyte dysfunction [2]. Recently, a polypill with multiple medications has been advised to prevent cardiovascular diseases (CVDs) [3]. This communication aims to emphasize that preventive therapy with certain drugs [3, 4] in low doses, may also enhance the capability of our body to adapt against the risk factors, resulting in the prevention of CVDs.

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