To the Editor.
—Dr Muller and colleagues1 have presented a fine service for patients rehabilitating from myocardial infarction (MI). Their conclusion affirms that of Hellerstein and Friedman2 26 years ago, which was based on 18 years of prior clinical experience and observation and correlation with results obtained from their benchmark study. Their study included a control group of patients at high risk for MI (those who have a family history of heart disease, overweight, and smokers) with normal vital signs, and their methods of observation included extensive history, physical examinations, and laboratory characterizations (ie, somatotype determinations, cholesterol and triglyceride measurements), and electrocardiograms (ECGs) at rest, during usual activity, and during sexual activity. Estimations of myocardial oxygen consumption were based on same-subject provocative testing in the laboratory. Psychological evaluations were conducted, including the Minnesota Multiphasic Personality Inventory and social indexing. Furthermore, the results contradicted laboratory observations of sexual activity