Ready to start an exercise program? That’s great, but before you start, I strongly suggest you get a health exam. An effective evaluation will help you identify any medical conditions or factors that put you at risk during exercise. The easiest and most effective way to do this is to work with your doctor to review your risk factors for coronary artery disease (CAD), the leading cause of death in the US. The eight positive risk factors (i.e. , increases the risk of CAD) identified by the American College of Sports Medicine (ACSM) are as follows:
1. Age. Men and 45 years and women and 55 years.
2. Smoking cigarettes. A current cigarette smoker or those who quit within the last 6 months; or exposure to environmental tobacco smoke (ie, secondhand smoke).
3. Family history. Heart attack or sudden death before age 55 in father or male first-degree relative (eg, brother) or before age 65 in mother or female first-degree relative (eg, sister).
4. Hypertension. Systolic blood pressure (SBP) of 140 mmHg or diastolic blood pressure (DBP) of 90 mmHg confirmed by measurements on at least two separate occasions; or on antihypertensive medication.
5. High cholesterol. LDL cholesterol > 130 mg/dL or HDL cholesterol < 40 mg/dL; or on lipid lowering medication. If total serum cholesterol is all that is available use > 200mg/dL.
6. fasting blood glucose. A fasting blood glucose of 100 mg/dL but < 126 mg/dL confirmed on at least two separate occasions.
7. obesity. Body mass index > 30. Also, waist circumference > 40 inches (102 cm) in men and > 35 inches (88 cm) in women.
8. sedentary lifestyle. People who do not get 30 minutes of moderate-intensity physical activity on most days of the week.
There is also a negative risk factor. A high serum HDL > 60 mg/dL reduces the risk of cardiovascular disease. ACSM provides a risk stratification to determine if you are within a Low, Moderate gold High risk category. If you’re low risk, you’re ready to start your exercise regimen. However, if you are at moderate risk or high risk, I strongly recommend that you have a complete physical exam by your doctor before beginning an exercise program.. This is particularly important if you plan to do high-intensity exercise. Your doctor may have specific guidelines for exercises you can and cannot do, and may want to provide you with an exercise test (eg, stress test) before giving you permission to start your program:
* Low Risk: Men and women who are asymptomatic (no existing disease or symptoms of disease) and have no more than one positive risk factor.
* Moderate risk: asymptomatic men and women but with two or more positive risk factors.
* High Risk: Anyone with existing disease or symptoms of disease (eg, diabetes, asthma, kidney or liver disease, lung disease, cardiovascular disease, cystic fibrosis, angina, heart murmur, dizziness, shortness of breath).