The findings of Blumenthal et al. (10) raise a practical question. Overall, current American society is highly sedentary and depressed patients even more so. Comorbid depression and cardiac disease make exercise instruction and maintenance more complex. Although some depressed patients may simply respond to their physician instructions concerning exercise, many will require more assistance than practicing doctors can provide in constrained medical practice. In the present study, group exercise for cardiac patients was freely sponsored through funded research. But in the real world, there is currently no third-party payer support for exercise training programs for cardiac patients besides conventional cardiac rehabilitation, which is relatively costly, limited in geographic availability, and narrow in its patient eligibility requirements. Thus, future research should address the realities of this situation. A practical line of exploration lies in the medical testing of inexpensive hospital or community exercise programs that provide either home-based and/or group-based exercise and adherence assistance, such as that provided by peer-based and professional social support, pedometer-based self-monitoring, and coaching assistance designed to increase patient autonomy, self-efficacy, and stress management (21). Such exercise programs can be tested versus conventional medical practice for their ability to reduce depression and important sequelae, such as medication noncompliance, work absenteeism, and the high utilization of medical resources that is associated with depression. The clinical reasons for developing such exercise programs are already compelling, but by demonstrating the efficacy of exercise versus antidepressant medication for reducing depressive symptoms, Blumenthal et al. (10) have now provided an important additional incentive for developing practical exercise programs for medical patients.