A polypill combining three medications for heart failure with reduced ejection fraction (HFrEF) demonstrated significant improvements in heart function, reduced hospitalizations, and better quality of life compared to standard separate-pill regimens, according to research presented at the American Heart Association's Scientific Sessions 2025. The study, which focused on socially disadvantaged populations, found that patients taking the once-daily combination pill had 3.4% higher absolute left ventricular ejection fraction, more than 50% reduction in heart failure-related hospitalizations and emergency visits, and substantially improved medication adherence.
The clinical trial included 212 adults with HFrEF who were not receiving guideline-recommended treatment. Participants were randomly assigned to either the 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 the once-daily polypill formulation. The study population represented medically underserved communities, with 68% having no health insurance or county-sponsored coverage, 42% reporting food insecurity, and 32% experiencing housing instability.
After six months, the polypill group showed remarkable improvements across multiple measures. Left ventricular ejection fraction increased by 3% more than the standard care group, indicating improved heart pumping function. Perhaps most notably, heart failure-related hospitalizations and emergency room visits were reduced by 60% in the polypill group. Quality of life scores measured by the Kansas City Cardiomyopathy Questionnaire-12 showed a significant 9-point improvement (72 vs. 63 points on a 100-point scale), meaning patients experienced less fatigue, fewer symptoms, and better overall well-being.
Medication adherence proved substantially better with the polypill approach. Blood tests confirmed that 79% of polypill patients had detectable levels of the tested medications compared to only 54% in the standard care group, representing more than 4-fold greater odds of taking all tested medications. Study author Ambarish Pandey, M.D., M.S., FAHA, from UT Southwestern Medical Center, noted that despite important treatment advances for heart failure, only 15% of patients receive all guideline-recommended therapies after hospitalization, highlighting the critical need for simplified treatment approaches.
The findings are particularly significant given the growing burden of heart failure in the United States. According to American Heart Association data available at https://www.heart.org, approximately 6.7 million adults are living with heart failure, with cases expected to increase to more than 8 million by 2030. Heart failure with reduced ejection fraction, where the heart's pumping ability is significantly impaired (ejection fraction ≤40%), represents a substantial portion of these cases and carries high rates of hospitalization and mortality.
This study represents the first evaluation of a polypill strategy specifically for HFrEF patients, with a focus on improving medication adherence and simplifying complex treatment regimens. The research team plans additional studies to evaluate broader implementation of the polypill approach in heart failure management. The complete study abstract can be found in the American Heart Association Scientific Sessions 2025 Online Program Planner at https://professional.heart.org. While these findings are considered preliminary until published in a peer-reviewed journal, they offer promising evidence for addressing the critical challenge of medication non-adherence in heart failure management, particularly among vulnerable populations who face multiple barriers to consistent care.
