Reducing the risk of heart disease and stroke.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States, responsible for almost 50% of all deaths. Compelling scientific evidence, including data from recent studies in patients with coronary artery disease (CAD), demonstrates that comprehensive risk factor interventions-including regular physical activity-augment physical work capacity, increase overall survival, improve quality of life, decrease the need for coronary revascularization procedures, and reduce the incidence of subsequent cardiovascular events ((1)). The rationale for this approach extends to patients with other documented atherosclerotic disease, (eg, transient ischemic attack, stroke ((2)), or aortic or peripheral vascular disease) because CAD is a leading cause of death and disability in these patient subsets. Not only do stroke and CAD share common risk factors (eg, hypertension, hypercholesterolemia, and diabetes mellitus), but 32% to 65% of stroke patients have CAD ((3)).