Exercise training in coronary artery disease

Physical training using dynamic, nonisometric exercise can increase physical endurance and decrease cardiac work load of submaximal exertion. This is true for people with coronary artery disease and for normal individuals, and it may also be true for those with selected other cardiac diseases. Effective training should involve exercise at between 70 and 85 per cent of predicted maximal heart rate for 15 to 20 minutes or more at least three times a week. An exercise prescription should be written on the basis of individual patient needs and limitations and utilizing an exercise electrocardiogram test. Medically supervised exercise programs allow physical training for patients with heart disease to be conducted safely and efficiently. The effect of training in coronary disease patients is primarily attributable to increased efficiency of peripheral musculature and circulation; how much true cardiac adaptation results is variable. Training improves psychologic outlook, probably reduces selected risk factors for coronary disease, and may improve longevity.