Although much less culpable than other therapeutic areas, even in cardiovascular medicine a thorough assessment of long-term tolerability and safety has not always been required of commonly used treatments. Indeed, until lately, hypertension and angina were each an example of such a departure from the high standards required in other conditions such as heart failure, -arrhythmias, hyperlipidaemia and myocardial infarction. Recent, prominent and disturbing examples of belated discovery of increased risk with both cardiovascular and non-cardiovascular drugs will ensure this laxity can never again occur . The experience with cerivas-tatin, the COX-2 inhibitors and nesiritide has highlighted the unacceptability of inadequate safety data for drugs destined to be used widely in patients with cardiovascular disease.
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