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(Circulation. 2005;112:2354-2363.)
© 2005 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Exercise Prescription and Proscription for Patients With Coronary Artery Disease

Paul D. Thompson, MD

From the Cardiac Rehabilitation and Cardiovascular Research, Henry Low Heart Center, Hartford Hospital, Hartford, and the University of Connecticut, Farmington.

Correspondence to Paul D. Thompson, MD, Cardiology, Hartford Hospital, 80 Seymour St, Hartford, CT 06102. E-mail pthomps@harthosp.org

Key Words: angina • claudication • coronary disease • exercise • heart failure

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Exercise training in patients with cardiovascular disease increases exercise capacity,^1–3 reduces cardiac ischemia,^1,2 delays the onset of or eliminates angina pectoris,^4,5 and improves endothelial function.⁶ Meta-analyses of exercise-based, cardiac rehabilitation studies have suggested that exercise training reduces cardiac mortality in coronary artery disease (CAD) patients.^7–10 A recent randomized, controlled comparison of exercise training and angioplasty in selected patients with angina documented fewer cardiac events in the exercise subjects over the year of follow-up.² Despite these benefits, exercise training is rarely prescribed for cardiac patients, as evidenced by the fact that only 20%^11,12 of qualified patients are referred to formal cardiac rehabilitation programs. Referral rates are even lower among women and older patients.¹³ The reasons for this underutilization are not defined but probably include health professionals’ underestimation of the benefits of exercise, a lack of training in exercise therapeutics among many healthcare providers, poor financial reimbursement, the absence of reimbursed advocates for exercise therapy,¹³ and the absence of a sufficiently large randomized clinical trial documenting a reduction in cardiac events. This review discusses the benefits of exercise training for patients with atherosclerotic cardiovascular disease.

Definition of Terms
The following terms are used in this article. Physical activity to refer to any bodily movement; exercise is used to indicate physical activity performed to stress primarily the oxygen transport system (aerobic exercise), muscular skeletal system (resistance exercise), or both. Exercise training indicates exercise performed repetitively to increase the maximal capacity of the oxygen transport (aerobic exercise training) or muscular skeletal (resistance exercise training) system. The terms . . . [Full Text of this Article]

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