March 2002 MedBytes

Cardiovascular Disease Guidelines and Rehabilitation

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Cardiovascular disease (CVD) and stroke, Texas' No. 1 and No. 3 killers, impose an economic burden on the state of more than $9 billion a year. It's no wonder, then, that the Texas Medical Association focuses so much of its member education resources on these chronic diseases. Project WATCH is the TMA and TMA Alliance CVD and stroke prevention initiative, financed by the TMA Foundation. The goal of the HeartCare Partnership (HCP) program is to improve risk factor management of patients with CVD. And the TMA Stroke Project (TMASP) is a continuing medical education (CME) program that teaches the knowledge and skills needed to reduce stroke morbidity and mortality.

This month's "MedBytes" looks at online resources for treatment guidelines and rehabilitation of CVD and stroke.

American College of Cardiology (ACC)
The vast content available at includes an extensive library of clinical statements and guidelines. The searchable list of treatment guidelines runs from "A" -- ACE (angiotensin-converting enzyme) inhibitors -- to "V" -- the use of Viagra (sildenafil) in patients with CVD. Pocket guidelines on the treatment of the most common forms of CVD, such as acute myocardial infarction, angina, and valvular heart disease, can be printed or loaded onto a handheld computer.

American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)
At, the material from this specialty society is limited in many areas. However, the AACVPR Outcome Tools Resource Guide in the publications section of this Web site provides in-depth coverage of the availability and characteristics of assessment tools for cardiopulmonary rehabilitation. The well-organized resource manual is heavy on psychological and behavioral materials, such as the "Harvard-Willet Food Frequency Questionnaire." For each tool, the AACVPR provides clinical references, costs, assessments of effectiveness and ease of use, and contact or ordering information.

My Heart Watch
Produced by the American Heart Association and American Stroke Association, this site at, is chock-full of heart attack and stroke prevention materials for patients and their caregivers. Features include healthy recipes, an online CVD risk assessment, and a program to help patients manage their health and their lifestyle with "interactive personalized tools and community support."

Virtual Office of the Surgeon General
The tobacco cessation guidelines at include materials for smokers and clinicians who want to help them snuff out their habit. For physicians and other health care professionals, the biggest attraction is the complete set of practice guidelines: "Treating Tobacco Use and Dependence." Fact sheets, quick reference guides, and support materials also are available in both English and Spanish.

Some other online resources to visit:

  • The "Publications, CME & Products" section of the American College of Chest Physicians Web site at is comprehensive.
  • The journals of the American Heart Association are all online at
  • The Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality) publishes its cardiac rehabilitation guidelines under "Clinical Practice Guidelines" at
  • For patients, the National Institutes of Health provides its interactive education program, "Your Guide to Lowering High Blood Pressure," at

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