December 5, 1980

Cardiac Rehabilitation

Author Affiliations

Centinela Hospital Inglewood, Calif

JAMA. 1980;244(22):2521. doi:10.1001/jama.1980.03310220023014

To the Editor.—  In her article on cardiac rehabilitation, Nanette K. Wenger, MD (242:2879, 1979), suggests that the "goals and objectives of exercise programs... after myocardial infarction require close scrutiny as to appropriate and inappropriate expectations." Then, she uses the work of Nolewajka et al1 to show that physical activity does not alter the natural history of the disease. I disagree.As I have stated previously (242:322, 1979), the "proper study" of the effects of exercise on the cardiac patient must involve exercise levels above the protective threshold of 10 km. I predicted2 that a total dose of 16,000 km of jogging would improve angiograms. I have reported such a case.3Thus, an "appropriate goal" of cardiac rehabilitation would be disease regression; all that remains to be determined in a given case is the total dose of the exercise prescription. No one should argue against the possibility