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Cardiac Rehabilitation and Changes in Lipid Values-Reply

Carl J. Lavie, MD; Richard V. Milani, MD
Arch Intern Med. 1993;153(22):2603. doi:10.1001/archinte.1993.00410220116015.
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We greatly appreciate Thomas' enthusiasm for cardiac rehabilitation services and his interest in our recently published article.1 As with many clinical studies involving data collected in busy clinical practices, our study had limitations that were outlined in the "Comment" section. However, we take exception to the opinion that the study limitations "invalidate most of our conclusions."

As we indicated in the text, a control group would be more essential if the main purpose of our study were to demonstrate the benefits of cardiac rehabilitation and exercise training on lipid values, obesity indexes, and exercise capacity. We believe that the benefits of exercise training alone or accompanied by other components of cardiac rehabilitation (dietary treatment, education, or stress management) have been demonstrated in many prior prospective, randomized studies reviewed elsewhere.2,3 The main purpose of our article, as indicated in the introduction, was to determine those factors predicting lipid improvements


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