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We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study. We defined high CVD risk as the presence of any of the following hypertension, coronary artery disease, stroke, smoker, diabetes or age 55 years. Availability and affordab