[Rationale for the pharmacologic treatment of cardiovascular diseases]

In what concerns the appropriate usage of drugs in the treatment of cardiovascular diseases, this paper provides a set of concepts and guidelines to aid the clinician in the choice of drug, the appropriate dose, the form of administration and the assessment of results. Therefore, the concepts of pharmacokinetics and pharmacodynamics which condition the administration regimen are also presented, as well as the notions of bioavailability, halflife and clearance in the light of the theory of the two compartments, quoting examples in the various pharmacologic groups currently used in cardiology. The main forms of administration and the respective indications are analysed and the concepts of tolerance, hypersensitivity and intolerance to a drug are also discussed. The importance of the major clinical trials in the assessment of the effects of drugs is supported, which consubstantiates the clinical decision based on scientific evidence. The notions of the efficacy and benefit of a treatment are presented, with examples of some recent clinical trials. The paper ends with a reference to the drug surveillance and cost-benefit studies.