In an effort to determine if more is better when it comes to cardiac rehabilitation, researchers analyzed data from 5% of the nation's Medicare beneficiaries, including more than 30,000 heart patients who had participated in at least one cardiac rehabilitation session between 2000 and 2005.

About half the patients attended 24 sessions or fewer, biostatistician and study researcher Bradley G. Hammill, MS, tells WebMD.

Over roughly four years of follow-up, patients who attended all 36 reimbursed sessions were:

* 47% less likely to die and 31% less likely to have a heart attack as patients who attended just one.
* 22% less likely to die and 23% less likely to have a heart attack than patients who attended 12 sessions.
* 14% less likely to die and a 12% less likely to have a heart attack than patients who attended 24 sessions.

The study will appear in the upcoming issue of the American Heart Association journal Circulation.

"Our findings indicate that more cardiac rehabilitation is better in almost every situation," Hammill says. "It may be that people who finish 36 sessions are already healthier or more diligent about their health. Or it may be that the programs really do change behaviors and lower risk."

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Boy, no kidding! From the sound of it, the study looked at older people whose conditions might've been more severe than mine after my heart attack, and their exercize sessions are monitored in a facility during formal sessions; but regardless of exactly how you do it, exercize after a heart attack is absolutely vital.

In my variation on this theme, I saw a physical therapist half a dozen times, more as consultations working out a self-directed exercize regime, what I'd call "modulated walking". Once it was set up, she sent me out into the world, and I really got into it. Within six months my heart function had improved from about half of normal to nearly normal. Hell yes it worked! These days I've been discharged by the Cardiology department and I'm on my own, and each day I walk an average of about 3 miles (twice the original target). I'm not going to stop walking.

If you're ever in this situation and have a choice between formal sessions and do-it-yourself, go with DIY. Walking is exercize that doesn't require fancy equipment except a good pair of shoes, and you can do it almost any time, almost any where. When I have to kill time, I go for a walk. Waiting for my car to get smog-checked, I walked a mile and a half to kill 30 minutes (20 minutes per mile). It's calibrated exercize. You can cut it off the roll to fit.

In a somewhat bizarre aside, this scientific study is reinforcing two superstitions I deliberately allow myself to hold: The stick is that I could drop dead if I miss a day of walking; the carrot is that I won't drop dead any day I walk. Of course it's over-the-top, but as motivators they're useful superstitions, and dang, now a scientific study says that there's a kernel of truth in my superstitions!