Thirty men, mean age 55 years, known to have treadmill-induced ischemic ST-segment depression, performed static dynamic effort, i.e., forearm lifting treadmill exercise, separately combined. Static effort was sustained at 20%, 25% or 30% of maximal forearm lifting capacity. Two symptomlimited treadmill tests, one with one without added static effort, were performed on each of two visits. Compared with dynamic effort alone, combined static-dynamic effort decreased treadmill work load increased heart rate, systolic blood pressure rate-pressure product at the onset of ischemic ST-segment depression or angina pectoris: 7.1 ± 0.4 vs 8.0 ± 0.5 (SEM) multiples of resting oxygen consumption (mets), estimated; 141 ± 3 vs 134 ± 3 beats/min; 170 ± 4 vs. 162 ± 4 mm Hg 239 ± 8 vs 218 ± 9 (p ≤ 0.001). The prevalence of angina pectoris was significantly less with combined static-dynamic effort than with dynamic effort alone. Static effort causes a resetting of the threshold at which ischemic abnormalities appear during dynamic effort.