The therapeutic acquisition to be retained for 2004 are: 1. The elderly patients with heart failure also should receive beta blocker treatment. The correction of anaemia, aggravating factor in heart failure, improves symptoms and survival of the patient. 2. It remains to prove that the treatment of sleep apnea, which seems to be an additional factor for mortality in cardiovascular diseases, is able to reduce the risk. 3. The interventions in the endocanabinoid system which regulates weight and metabolic processes might be a promising new therapeutic acquisition. 4. Prevention of coronary disease with lipid lowering drugs is still a major topic, and the trend goes the lower the better. The problems observed with Rofecoxybe and other drug interactions reminds us to be conscious when prescribing multiple drugs. 5. The implantable defibrillator seems to be a life insurance in the event of ventricular fibrillation. However, it is not so easy to identify the patient who might really benefit.