My main concern regarding the running of a MySQL database driven website is that servers to die, and having a backup is essential. However, without an automated backup solution, you are likely to find that when you most need it, your backup is old.
Fortunately a plugin has been written for WordPress which not only allows you to manually backup your database from your site control panel, but also allows you to set up an automated backup that is emailed to a destination of choice. So you could if you desired, back up your database to a gmail account, where it should be safer than a home pc or the same web server that your website is hosted on.
I am still testing WP-DBManager 2.30 now, but have set it to automatically backup my database every 12 hours, then GZip it and email to myself. The auto backup can be set in minutes, hours, days, weeks or months, so depending on how active your site is there should be a backup solution for you. Hopefully testing will prove positive.
In addition to backing up the WordPress MySQL database, WP-DBManager 2.30 also allows you to restore a database, manage existing backups, run SQL queries, repair the database and drop or empty tables. Emptying a table could be useful if you find that you suddenly have thousands of unwanted spam messages. Just empty the whole comments table, and the message will all go. Drastic, but if you have a backup, you could then just import the comments, rather than importing the entire database.
Finally WP-DBManager 2.30 has the function to optimise the database to ensure smooth running and fast responses.
If I find any problems with this plugin I will report it here, but so far it looks like a very useful plugin for any WordPress bloggers.