Acsm Cad Risk Factor Thresholds
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1ACSM Coronary Artery Disease Risk Factor Thresholds
Risk Factors
Defining Criteria
Score
Family history
MI, coronary revascularization, or sudden death in an immediate
+1
relative (male <55 years or female <65 years)
Cigarette Smoking
Current smoker or those who quit within the past 6 months
+1
Hypertension
SBP ≥140 mmHg or DBP ≥90 mmHg confirmed by
+1
measurements on at least two separate occasions, or on
antihypertensive medication
Dyslipidemia
Total >200 mg/dL or HDL <40 mg/dL or LDL >130 mg/dL; if
+1
LDL >130 mg/dL, use LDL rather than total >200 mg/dL, or on
lipid-lowering medication
Impaired Fasting Glucose
Fasting blood glucose ≥ 100 mg/dL confirmed on two separate
+1
occasions
Obesity
BMI >30, or waist girth >102 cm (40 in) for men and > 88 cm
+1
(35 in) for women, or waist-to-hip ratio ≥ 0.95 for men and ≥
0.86 for women
Sedentary Lifestyle
Persons not participating in a regular exercise program or
+1
accumulating 30 minutes or more of moderate physical activity
on most days of the week
High Serum HDL
>60 mg/dL
– 1
SCORE
Initial ACSM Risk Stratification
Low Risk (younger)
____ Men <45 years of age AND no more than one positive risk factor
____ Women <55 years of age AND no more than one positive risk factor
Moderate Risk (older)
____ Men 45 or older
____ Women 55 or older
____ Those who meet the threshold for two or more positive risk factors
High Risk
____ Cardiac, peripheral vascular, or cerebrovascular disease
____ Chronic OPD, asthma, interstitial lung disease, or cystic fibrosis
____ Diabetes mellitus type 1 or 2, thyroid disorders, renal, or liver disease
Those with one or more of the following signs or symptoms:
____ Angina
____ Ankle edema
____ Shortness of breath at rest or with mild exertion
____ Palpitations or tachycardia
____ Dizziness or syncope
____ Intermittent claudication
____ Orthopnea or paroxysmal nocturnal dyspnea
____ Known heart murmur
____ Unusual fatigue or shortness of breath with usual activities
Participation and (B)
ACSM Recommendations for (A) Current Medical Examination and Exercise Testing Prior to
Physician Supervision of Exercise Tests
Low Risk
Moderate Risk
High Risk
A.
Moderate Exercise
Not Necessary
Not Necessary
Recommended
(40–60% VO
max)
2
Vigorous Exercise
Not Necessary
Recommended
Recommended
(>60% VO
max)
2
B.
Submaximal Test
Not Necessary
Not Necessary
Recommended
Maximal Test
Not Necessary
Recommended
Recommended
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