Author Affiliations: Preventive and Rehabilitative Cardiac Center, Division of Cardiology, Department of Medicine, and the Burns and Allen Research Institute, Cedars-Sinai Medical Center; and the Department of Medicine, University of California School of Medicine, Los Angeles, Calif.
Exercise training is an effective treatment for coronary artery disease.
Medically supervised exercise has been demonstrated to halt progression and
enhance regression of angiographic stenoses,1
reduce myocardial stress perfusion defects,2
enhance quality of life,3 and reduce mortality.4,5 Compared with other currently available
therapies for coronary artery disease, the 25% risk reduction observed with
exercise is comparable with the 20% achieved with aspirin,6
the 20% with β blockers,7 and the 15%
observed with angiotensin-converting enzyme inhibitors.8
Because the studies demonstrating overall mortality reduction were performed
prior to the use of thrombolysis and aggressive revascularization therapy,
the net additional benefit of supervised exercise in these lower-risk populations
is unknown. Nevertheless, based on these and other randomized controlled trial
data, the Agency for Health Care Policy and Research Cardiac
Rehabilitation Guidelines9 call for
universal application of medically supervised exercise for the more than 12
million patients with established coronary artery disease.
Bairey Merz CN, Paul-Labrador M, Vongvanich P. Time to Reevaluate Risk Stratification Guidelines for Medically Supervised Exercise Training in Patients With Coronary Artery Disease. JAMA. 2000;283(11):1476-1478. doi:10.1001/jama.283.11.1476