A long-term training program was performed on 30 chronic hypertensive female patients, stages I-II, WHO criteria. The effect on blood pressure (BP) and other physiological parameters, as exercise BP, heart rate, physical working capacity, VO_2max, double product, were studied. Four phases were outlined throughout the trial: (1)3 months training at 70% of the maximal heart rate; (2) 3 months without training; (3) 1 year training at the same level as phase I, and (4) 12 or more months with increasing intensity training over 70 % of the maximal heart rate. Serial ergometric work tests were performed every 3 months.We observed a close relationship between physical working capacity and VO_2max increases with training intensity. Resting BP fell significantly with training (182/114-161/97 mm Hg; p < 0.001) but increased again when training was discontinued (161/97-179/115 mm Hg; p < 0.001). BP persisted low throughout the trial, but there was a tendency to a further but not significant decrease when training intensity was raised over 70% of the maximal heart rate. Both the submaximal and maximal exercise BP showed similar changes to those found in the resting BP throughout the trial. The submaximal heart rate and the double product (BP X heart rate) also fell significantly with training but with maximal values not changing significantly throughout the whole follow-up period.

Since the effect of cardiac rehabilitation (CR) on morbidity and mortality due to myocardial infarction on a long-term basis appears controversial, a controlled follow-up survey was conducted from 1973 to 1981 in 193 patients suffering a first acute myocardial infarction (AMI). The admission criteria included absence of contraindications to CR during the acute phase of AMI. Patients were divided into two matched groups: 93 patients followed a CR program, exercising 30 min three times a week (x 42; range 6–108 months) and the remaining 100 patients served as controls. Age, sex, location and extension of the myocardial damage, frequency of coronary risk factors and complications during the acute phase were comparable. At 9 years, there were 24 cardiac deaths (15 AMI, 7 sudden deaths and 2 heart failures) among the controls and 13 deaths in the CR group (7 AMI, 4 sudden deaths, 2 heart failures), mortality rates being 5.2 and 2.9% per year (p < 0.1 > 0.05; NS), respectively. There were 23 recurrent AMI in the control versus 16 in the CR patients, the corresponding rates being 4.9 and 3.6% per year, respectively (NS). Nor were any differences observed in the incidence of myocardial ischemia, severe arrhythmias or cerebrovascular strokes between both groups, but the appearance of angina was significantly lower in the CR group compared with the controls (5.1 and 10.2% per year, respectively, p < 0.005). It is concluded that CR on a long-term basis seems to improve the mortality rate of AMI and to reduce the frequency of anginal pain.