Cardiovascular Diseases and Pharmacoepidemiology : Present and Future

The history of pharmacoepidemiology in Japan is short, and despite its importance for physicians in prescribing medicine in daily clinical work, their interest in this evidence-based science has been far from social acceptance. Pharmacoepidemiology itself especially in Japan must be firmly established with systematically constructed harmonious features defined by pharmaceutical health promotion consisting of four independent facets ; health professionals, consumer, industry and regulatory faces. Also, pharmacoepidemiology has to be developed on a scientific basis for outcome research focusing on the clinical and economic consequences of drug therapy decisions. Persuing this aim, pharmacoepidemiology will need to simultaneously invoke principles in other scientific fields such as molecular biology, biostatistics and genetic epidemiology. Ultimately, these interdisciplinary synergies can contribute to intelligent and hopefully more efficient drug development, and a better understanding of what will happen when the drug goes to market. In the clinical field of cardiology, on the other hand, numerous facets are involved in pharmacoepidemiology ; PMDS, polypharmacy and genetic aspects in gene polymorphism with special regard to LQT syndrome and anticoagulation with warfarin. These clinical factors associated with pharmacoepidemiology are summarized and discussed in detail.