1. Fitness: Measured at baseline and 8wk in the JPCHH using the Bruce protocol exercise tolerance test. The total time exercised will be determined. For the primary endpoint, similar to prior studies, the investigators will calculate the proportion of patients achieving an increase in 1 min from baseline to 8 weeks and compare this proportion between groups. A 1 min increase corresponds to a 1 to 1.5 metabolic equivalent increase on the Bruce protocol; this translates to a projected 12% to 50% reduction in mortality.