Preventing coronary heart disease is an important issue of medicine. Suitability of physical exercise for primary or secondary prevention is discussed positively in literature. It's efficacy lacks significant proof because of a possible positive selection of patients. The concept of preventing coronary atherosclerosis by physical exercise should be of special value, because of it's favorable influence on the risk factors. A prerequisition is the optimazation of duration, intensity and type of training programs under the aspects of prophylactic cardiology. A sportmedical examination prior to training is a necessity for patients to evaluate their risk.