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A Letter from the President-Dr Lynne Braun

It is truly an honor to serve as the 2008-2009 President of the Preventive Cardiovascular Nurses Association (PCNA) and work with our members who represent the leaders in cardiovascular disease prevention. The Centers for Disease Control recently reported that coronary heart disease and stroke age-adjusted death rates were down by 25.8% and 24.4%, respectively, since 1999. This dramatic decrease is due in part to prevention efforts; however, the prevalence of risk factors remains high. Together, we must continue to develop effective programs and individual strategies to help our patients reduce their cardiovascular disease risk. We must also educate our healthcare colleagues about the importance of early prevention and speak to legislators about funding prevention services and programs.


Our membership represents a diverse group of nurses and other healthcare professionals with a variety of role responsibilities. In order to best serve members and non-members alike, our 14th Annual Symposium consisted of presentations and workshops addressing primary and secondary prevention in various subgroups, including older adults, underserved populations, acute coronary syndrome patients, heart failure, stroke, and renal disease patients.


It is my pleasure to introduce you to the new PCNA board members, Joyce Ross and Lola Coke. Joyce Ross is a nurse practitioner and clinical lipid specialist who practices at the University of Pennsylvania in the Cardiovascular Risk Intervention Program. She is also a clinical research coordinator and subinvestigator on several cardiovascular risk reduction trials for lipids and other risk factors. Joyce is a widely sought-after speaker for continuing education programs, including PCNA annual symposia, and serves as adjunct faculty in several universities. Joyce is an active member of numerous organizations, including PCNA, American Heart Association (AHA), Northeast Lipid Association (board member), and the Cardiovascular Institute of Philadelphia (board member).


Lola Coke is an assistant professor in the Department of Adult Health Nursing at Rush University College of Nursing in Chicago. She has experience working with community groups, specifically underserved populations. Lola developed and implemented a heart health program in a low-income housing project in Chicago. She is an active member of PCNA and AHA. Lola has served as chapter leader for the Chicagoland chapter of PCNA, participated in annual symposia, and assisted in planning the PCNA leadership conference. On behalf of the PCNA board members, I welcome both Joyce and Lola to the board and look forward to their leadership in PCNA.


2008 is an exciting election year! Nurses are 2.7 million strong, which means that if every nurse votes in the national election, he/she has the potential to influence health policy. The Advocacy Committee of PCNA is actively discussing ways to have a stronger presence in Washington, DC, to ensure that issues pertaining to cardiovascular disease prevention are brought to the forefront of American politics. However, PCNA members can have a voice in cardiovascular disease prevention by joining the advocacy network of our partner, the AHA, at Just click on Advocacy: You're the Cure (in the sidebar). You can ask your legislators to support the HEART for Women Act, which will improve the prevention, diagnosis, and treatment of heart disease and stroke by raising awareness among women and their healthcare providers. This Act will also provide gender- and race-specific information for clinicians and researchers, and improve screening for low-income women at risk for heart disease and stroke. When you join You're the Cure, you do not need to generate your own letters (unless you prefer). You will receive an e-mail alerting you to statewide and national issues pertaining to heart health. It is a matter of a couple clicks, and a letter is electronically sent to your legislators.


I look forward to working closely with PCNA members during the next year.


Yours sincerely,


Lynne T. Braun, PhD, CNP, FAHA


Preventive Cardiovascular Nurses Association Hosts 14th Annual Symposium

Orlando, Florida provided a great venue for empowering nurses in "Leading the Way in Prevention," the focus of the Preventive Cardiovascular Nurses Association's (PCNA) 14th Annual Symposium held on April 24 to 26, 2008.


Three breakfast programs were offered. Cardiometabolic risk reduction, presented by Dr Byron Hoogwerf and Beverly Thamassian, RN, BC-ADM, MPH, CDE, emphasized the intricate pathophysiology of insulin resistance, diabetes, and cardiovascular disease (CVD), with case studies demonstrating management approaches. Patrick McBride, MD, MPH, and Jane Nelson-Worel, MS, APN, challenged the audience in their talk about complex cases for lipid management. On the final day of the conference, Dr Annabelle Volgman and Janet Bond Brill, PhD, RD, LDN, discussed how to achieve optimal nutrition for cardiovascular health.


With that great start to each day, the rest of the program highlighted varied topics. Dr Haskell provided a clear discussion of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation trial and the role of percutaneous coronary interventions versus optimal medical care in stable but at risk patients. He made it clear that a very important component of the success of the medical therapy arm of the trial was the well-organized and trained case management team that provided the intensive risk reduction program. His take-home message was that these results cannot be attained in clinical practice without implementing similar "optimal medical therapy" programs. Dr Lloyd-Jones shared his methods for calculating the lifetime and age burden of CVD risk that can serve as an important motivator for change. As expected, Dr Libby provided outstanding graphic depictions of the pathophysiology of CAD, whereas Hilary Nierenberg, ANP, MPH, shared key breakthroughs in the treatment of acute coronary syndrome and myocardial infarction.


PCNA's programs consistently highlight the spectrum of individuals affected by CVD risk and how prevention can reverse expected outcomes. This was demonstrated by state-of-the-art information on how prevention fits with the geriatric patient, patients at risk for heart failure, and the underserved. Kathy Berra, MSN, ANP-BC, shared details of 2 Stanford programs that use nurse case managers to effectively reduce CV risk factors in the medically underserved. These programs work within existing public healthcare systems to support more focused practice patterns of CVD prevention and support the efforts of primary care providers.


Seven breakout sessions provided in-depth knowledge on a variety of topics: exercise pedometry and exercise for special populations, smoking cessation, dyslipidemia and complex patients, secondary causes of dyslipidemia, renal disease, and motivational interviewing. Finally, the program ended with an outstanding presentation by Dr Michael DeGeorgia on advances in cerebrovascular disease and understanding and breakthroughs in stroke management that have been nothing short of a revolution in stroke care. He described how throughout our US history, stroke has personally affected 10 presidents. In a novel manner, he explored as follows: "What if the strokes that these world leaders experienced had been treated with today's technology and today's medical and surgical approaches? Perhaps history would have been different."


PCNA's planning committee is already working on an exciting program for 2009. Save the date: April 16 to 18 in Dallas, Texas!


Kopin Awarded Terry Thomas Clinical Practice Award

The Preventive Cardiovascular Nurses Association (PCNA) congratulates Laurie Kopin, MS, ANP, on receiving the Terry Thomas Clinical Practice Award. Kopin was presented with this award at PCNA's 14th Annual Symposium, April 24, in Orlando, Florida.


This inaugural award, sponsored by PCNA, recognizes and encourages clinical excellence in cardiovascular disease prevention. More specifically, the award is presented to the candidate who has demonstrated the delivery of outstanding patient care, has made an effort to improve preventive cardiovascular nursing practice, and has contributed to the professional development of peers and colleagues.


Ms Kopin is an Associate Professor of Nursing at the University of Rochester, School of Nursing. She also holds a joint appointment as a Senior Instructor in the University of Rochester, School of Medicine, in the Department of Community and Preventive Medicine. Currently, she serves as the faculty course coordinator for the Masters in Public Health course, "Health Promotion and Preventive Medicine." She also teaches a graduate level nursing elective in the School of Nursing entitled "Preventive Healthcare and Wellness."


Kopin is the author of numerous articles, book chapters, and web-based learning modules in the area of preventive cardiology and lipid management. She serves as an author and editor for the American College of Physicians, the American Society of Internal Medicine, and the National Lipid Education Council.


Presently, Ms Kopin serves as either a co-principal investigator or a co-investigator for several clinical research trials including two which were awarded by the National Heart, Lung, and Blood Institute. Professional and community outreach efforts include collaborative efforts with both local and national organizations. She is President of the Northeast New York Regional Chapter of the PCNA and serves on the American Heart Association Council on Cardiovascular Nursing, National Cardiovascular Disease Prevention Subcommittee. Internationally, she serves on the Executive Curriculum Committee for the World Heart Federation.


Preventive Cardiovascular Nurses Association Proudly Supports Resourcefully Enhancing Aging in Specialty Nursing

In October 2007, The Hartford Institute for Geriatric Nursing received funding for its initiative Resourcefully Enhancing Aging in Specialty Nursing (REASN). This initiative is a continuation of the Hartford Institute's work with specialty nursing associations to enhance geriatric competency of nurses. REASN is a collaboration of 13 hospital-based specialty nursing associations representing more than 200,000 specialty nurses. Its goal is to create new and sustainable geriatric educational products and resources and assure the geriatric competence of their members.


The Preventive Cardiovascular Nurses Association (PCNA) was invited to join this initiative to fulfill the need for the educational resources related to the prevention and management of cardiovascular disease and the elderly population.


Among the resources on prevention and management of cardiovascular disease is the geriatric nursing link found at This site includes information on useful geriatric resources available to healthcare providers, such as "Try This," a series of assessment tools focusing on specific topics relating to the older adult population; "ElderWeb," a research site for those looking for information on eldercare and long-term care; NIHSeniorHealth, a web site for older adults containing information about health issues such as cancer, arthritis, and diabetes; and PCNA's "Get Tough on Angina," a free educational resource which provides information on living with angina.


For more information about this initiative, please visit

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Preventive Cardiovascular Nurses Association Advocacy Committee Alerts Public

On January 1, 2005, a total of 3 new categories of preventive services were added to The Medicare Prescription Drug, Improvement, and Modernization Act of 2003. They include a provision for an initial preventive physical examination, cardiovascular screening blood tests, and diabetes screening tests. Many providers are unaware of this insurance coverage and, as a result, have not ordered available tests for their Medicare recipients. There is concern that the coverage will be eliminated if these benefits are not used. The Preventive Cardiovascular Nurses Association (PCNA) Advocacy Committee would like to bring this to the attention of readers in order to take advantage of the following benefits.


The initial preventive physical examination is a one-time physical examination that is offered to those Medicare recipients who began part B coverage, January 1, 2005, to the present. The examination must be completed within 6 months after the part B coverage becomes effective. If the beneficiary is found to have risk factors for abdominal aortic aneurysm after the initial preventive physical examination, Medicare will cover an abdominal ultrasound screening. This is a once per lifetime test and became effective January 1, 2007. A co-payment is required for each examination.


The cardiovascular disease screening includes a 12-hour fasting cholesterol, triglyceride, and high-density lipoprotein test and is offered every 5 years if the individual does not have a diagnosis of cardiovascular disease. Medicare does not charge a deductible or co-pay. This is not for patients who have a diagnosis of dyslipidemia, hypertension, coronary artery disease, or vascular disease. Those patients would be monitored and covered because of their disease.

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A diabetes screening test is offered to individuals with risk factors for diabetes or diagnosed with prediabetes. Individuals who already have diabetes are not eligible. The benefit allows for 2 free screening tests per year for those with prediabetes and one screening per year if previously tested but with no evidence of prediabetes. For patients with diabetes who need self-management training, up to 10 hours of initial training is available within a continuous 12-month period and up to 2 hours of follow-up training each subsequent year. A co-payment is required. For patients with a diagnosis of diabetes or renal disease, medical nutrition therapy is offered as 3 hours of one-on-one counseling in the first year and 2 hours in subsequent years. A co-payment is required.


Smoking and tobacco cessation counseling is available with coverage including a specific number of intervention attempts per year.


Other preventive services include pap tests, pelvic examination, mammography, bone mass measurements, colorectal cancer screening, prostate cancer screening, glaucoma screening, influenza, pneumococcal, and hepatitis B vaccine.


The PCNA Advocacy Committee, which monitors reimbursement and related issues on behalf of PCNA members, encourages you to review the services at The quick reference guide explains each benefit along with the Current Procedural Terminology and International Classification of Diseases, Ninth Revision codes. This can be found at:


May Is National Stroke Awareness Month

The goal of this annual campaign is to raise public awareness about stroke risk factors, prevention, symptom recognition, and acting fast to treat stroke. In addition, this is a time for remembering those who have survived a stroke and to let them know that we are here for them throughout their lifelong recovery journey.


Act FAST. This acronym stands for face, arms, speech, and time. If you think someone may be having a stroke, perform this simple test:


Face: ask the person to smile. Does one side of the face droop?


Arms: ask the person to raise both arms. Does one arm drift downward?


Speech: ask the person to repeat a simple sentence. Are the words slurred? Can he/she repeat the sentence correctly?


Time: if the person shows any of these symptoms, time is important. Call 911; get to the hospital fast. Brain cells are dying.


Remembering this acronym and teaching it to your patients and their significant others help to increase awareness of stroke symptoms and the importance of accessing the healthcare system promptly.


As with atherosclerotic cardiovascular diseases, stroke is preventable. Teach your patients about the uncontrollable risk factors for stroke: being older than 55 years, male, African American, Hispanic, Asian/Pacific Islander, or having a family history of stroke. Work with your patients to control stroke risk factors that are treatable with lifestyle change and/or medications. These include hypertension, hyperlipidemia, tobacco use, sedentary lifestyle, diabetes, and atrial fibrillation. The National Stroke Association's web site,, has helpful information for patients regarding stroke prevention and treatment as well as a stroke risk scorecard to help them get an idea of their personal stroke risk.


Professionals may wish to take this opportunity to review the 2006 "Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack" published by the American Heart Association/American Stroke Association. This evidence-based guideline is available at or in the publication: Stroke. 2006;37:577-617.


Section Description

The Journal of Cardiovascular Nursing is the official journal of the Preventive Cardiovascular Nurses Association. PCNA is the leading nursing organization dedicated to preventing cardiovascular disease through assessing risk, facilitating lifestyle changes, and guiding individuals to achieve treatment goals.