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Starting incline and speed were individualized and were chosen so that angina was provoked during the second 3-minute stage. Exercise was performed until the patient signaled the onset of definite angina, at which point the timer was stopped. Training to the point of stable performance (onset of angina at a constant time ±30 s) typically required 10 to 15 exercise bouts to angina over a 2 to 3 week period. Between the beginning and the end of the training period, there was usually an improvement of at least one 3-minute stage in exercise capacity. ISDN Titration All patients successfully completing the training phase went through a titration and treatment phase with isosorbide dinitrate (ISDN). The method for evaluating nitrate responsiveness and tolerance and performing dose titration was the performance of two exercise bouts, one before and another 1 hour after a dose of ISDN. Criteria tor an adequate response were at least a 2-mmute increase in exercise duration to angina (typically, but not invariably accompanied by a fall of 15 to 20 mm Hg in resting systolic blood pressure) and the absence of a significant improvement following the singleblind administration of a matching placebo. Titration was begun with 10 mg of ISDN or the patient s usual dose.