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Trends in life are governed by internal stresses and outside influences. New drugs are subject to the same pressures. Innovation in a therapeutic field is usually followed by the synthesis of a number of derivatives of the original compound which is eventually exhausted, and this has influence on the number of “single new drugs” introduced annually. Such exhaustion has not occurred with cardiovascular drugs because new ideas have also been introduced. For this reason, drugs in this category available in other countries but not in the United States are here described in detail. This analysis will also show that there is a “drug lag𠇟 in transferring a new drug from one country to another in Europe and that this is not purely an American phenomenon.

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