The placebo effect in cardiovascular disease.

The effect of placebo on the clinical course of systemic hypertension, angina pectoris, silent myocardial ischemia, CHF, and ventricular tachyarrhythmias has been well described. In the prevention of myocardial infarction, there appears to be a direct relation between compliance with placebo treatment and favorable clinical outcomes. The safety of short-term placebo-controlled trials has now been well documented in studies of drug treatment of angina pectoris. Although the ethical basis of performing placebo-controlled trials continues to be challenged in the evaluation of drugs for treating cardiovascular disease, as long as a life-saving treatment is not being denied it remains prudent to perform placebo-controlled studies for obtaining scientific information.