Pharmacological manipulation of programmed cell death could provide a breakthrough in the prevention and treatment of congestive heart failure, inflammatory heart diseases, and vascular lesions. This novel therapeutic approach is based on the inhibition or induction of cell death, depending on the type of disease and cardiovascular cell. Unexplored drug targets should be identified with a view to modulating gene expression in cardiac myocytes. Induction of apoptosis of fibroblasts or myofibroblasts by selective and potent compounds could limit fibrosis. Specific elimination of activated macrophages at the level of vascular lesions might be useful, but selective manipulation of apoptosis or survival of cardiac myocytes, endothelial cells, fibroblasts, and leukocytes should take into account the role of proand antiapoptotic factors that are recruited during the progression of a given disease...