The dynamics was studied of tolerance to physical load in the course of three-year prophylactic medical care of 60 male with ischemic heart disease (functional class II-III) against the background of antianginal therapy related to presence or absence of collateral blood flow as evidenced by coronaroangiography. The presence of collateral blood flow in patients with ischemic heart disease is considered as a sign of marked hemodynamic disorder in the system of the stenosed blood vessel leading to myocardial ischemia, reduction of the contractile function and a more severe clinical course of ischemic heart disease with a possible development of reinfarctions of the myocardium and advancing reduction of tolerance to physical load.