Practical information is provided for clinicians who may be called upon to evaluate and manage the workplace as a potential source of increased risk for cardiovascular disease (CVD). The possibilities and limitations of stress management programs focusing on the individual, as well as the need for complementary organizational job redesign approaches, are presented. We raise the question: could lowering of job strain be a specific therapeutic modality for workplace-related hypertension, and we view this in light of the efficacy of pharmacologic, as well as other individual-based approaches to managing elevated blood pressure. Guidelines for the clinician to help determine the effectiveness of work-based intervention trials focused upon CVD prevention and to define critical endpoints for various clinical groups, are discussed, together with some clinical-methodological caveats for interpretation of findings. Finally, an argument is presented that a public health perspective is needed to effectively tackle work-related CVD, with incorporation of the concept of "occupational sentinal health event" into the realm of cardiology. As the role and potential contribution of the clinician in this process become better defined, possibilities emerge for him or her to become a truly effective agent for change, in improving the work environment.