[Possibilities and limits of ambulatory coronary groups]

Physical exercise has become more and more popular as a treatment method in outpatients with coronary artery disease. The number of outpatient groups in the Federal Republic of Germany grew from 80 to 424 groups between 1978 and 1982. Exercise may have a favourable effect on various cardiovascular risk factors because it reduces bodyweight, blood pressure, LDL and VDL cholesterol and raises HDL cholesterol. It also improves work tolerance by raising the double product of heart rate and blood pressure at comparable workloads, as well as stroke volume and arteriovenous oxygen difference; the result is reduced myocardial oxygen demand. The favourable effect of exercise on the prognosis of patients after myocardial infarction has thus far only been demonstrated in one randomized study (14). That this has not been possible in other studies is mainly due to methodological problems such as sample size, drop-out, drop-in, and others. Nevertheless, it may be concluded that correctly conducted physical training in carefully selected patients with coronary artery disease improves cardiovascular function, quality of life and possibly even prognosis.