Specific strategies for reducing exercise-related cardiovascu- lar events have not been evaluated. It seems prudent, how- ever, that patients at high risk of cardiac complications (ie, those with a history of multiple MIs or cardiac arrest, New York Heart Association functional class III or IV or exercise capacity ,6 METs, or significant exercise-induced ischemia on treadmill testing) participate in a medically supervised program for at least 8 to 12 weeks to establish the safety of the prescribed exercise regimen. The value of resistance exercise increasingly is recognized for improving functional capacity, independence, and quality of life in patients with and without cardiovascular disease. Although the risks and benefits of resistance therapy have not been evaluated extensively in patients with SIHD, several small studies have indicated that resistance therapy is well tolerated and is associated with improvements in quality of life, strength, and endurance when added to a program of regular aerobic exercise.611,612 Although previous guidelines have recommended that all patients undergo an exercise test before participating in a cardiac rehabilitation program, according to the World Health Organization,634 an exercise test is not considered necessary for medical and economic reasons if the patient enters a low- or moderate-intensity-level training program. 4.4.1.5. Weight Management Class I 1. BMI and/or waist circumference should be assessed at every visit, and the clinician should consistently encourage weight maintenance or reduction through an appropriate balance of lifestyle physical activity, structured exercise, caloric intake, and formal be- havioral programs when indicated to maintain or achieve a BMI between 18.5 and 24.9 kg/m2 and a waist circumference less than 102 cm (40 inches) in men and less than 88 cm (35 inches) in women (less for certain racial groups).257,449,635 642 (Level of Evidence: B) 2. 