This study compared the ventilatory threshold with the double-product break point in 104 patients with cardiovascular disease during ramp treadmill testing. The high correlation (r = 0.81) between the double-product break point and the ventilatory threshold, even in patients taking beta blockers, suggests the former method is a viable noninvasive alternative for identifying the anaerobic threshold in patients with cardiovascular disease, particularly when expired gas analysis is not appropriate or available.