The Benefits and Risks of Exercise Training in Patients With Chronic Coronary Artery Disease

WILLIAM Heberden, in hisCommentaries on the History and Cure of Diseasespublished in 1802, had "little or nothing to advance..." for the treatment of angina pectoris but did know of one patient "who set himself a task of sawing wood for half an hour every day and was nearly cured."1Heberden's observation that physical training can nearly cure angina in some patients has been confirmed in recent studies,2-4and physical training remains one of the most effective methods for improving the functional capacity and psychological well-being of selected patients with coronary artery disease (CAD). This article summarizes the effect of CAD on exercise tolerance and the benefits and risks of exercise training in patients with CAD. ACUTE CARDIOVASCULAR RESPONSE TO EXERCISE Healthy Subjects A brief review of the normal cardiovascular response to exercise is necessary to understand how CAD alters exercise performance. Functional capacity during dynamic exercise