People who have heart attacks frequently have psychological problems and social difficulties afterwards but those who join exercise programmes, which give them confidence, are known to do better.
An Australian study in tomorrow's British Medical Journal looks at 224 men who were allocated either an intense exercise programme or a gentler one over three years.
The strenuous programme consisted of three one-hour classes a week of gym exercises; the lighter programme comprised two one-hour sessions of stretching and other exercises with rests in between. The patients were asked to walk for 30 minutes every day.
Dr Marian Worcester, director of the Heart Research Centre, Victoria, says that although greater fitness was seen from physical measurements after the strenuous exercise, the effect was short-lived.
When the researchers measured quality of life and looked at how soon the patients returned to work they could find little difference. Being involved in a group may be important in helping patients recover fully, they said.