A Previously Healthy 5-Year-Old Girl Is Brought To The Physician Assessing the Risks of an Exercise Program

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Assessing the Risks of an Exercise Program

Ready to start an exercise program? That’s great, but before you start, I highly recommend doing a health check. Effective screening 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 review your risk factors with your doctor for coronary artery disease (CAD), the number one killer in the United States The Council of Sports Medicine (ACSM) states the following:

1. age. 45 years old for men and 55 years old for women.

2. smoking. A current smoker or a person who has quit smoking within the past 6 months; or has been exposed to environmental tobacco smoke (ie, second-hand smoke).

3. family historyHeart attack or sudden death of a father or first-degree male relative (eg, brother) before age 55 or mother or first-degree female relative (eg, sister) before age 65.

4. hypertension. Systolic blood pressure (SBP) e 140 mmHg or diastolic blood pressure (DBP) e 90 mmHg confirmed by at least two independent measurements; or taking 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 > 200 mg/dl.

6. fasting blood sugar. Fasting blood glucosee 100 mg/dL but < 126 mg/dL was demonstrated 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 did not get 30 minutes of moderate-intensity physical activity most days of the week.

There is also a negative risk factor. High serum HDL > 60 mg/dL reduces the risk of cardiovascular disease. ACSM provides risk stratification to determine if you are low, ease or high risk category. If you’re low risk, you’re ready to start your exercise regimen. However, if you are moderate or high risk, I strongly recommend that you get a full physical exam with your doctor before starting an exercise program. This is especially important if you plan to do high-intensity exercise. Your doctor may have specific guidelines on what exercises you can and cannot do, and he or she may want to perform exercise tests (for example, stress tests) before allowing you to start your program:

*Low Risk – Men and women who are asymptomatic (no existing disease or disease symptoms) and no more than one positive risk factor.

*Intermediate risk – asymptomatic men and women with two or more positive risk factors.

*High Risk – Anyone with an existing medical condition or symptoms of a disease (eg, diabetes, asthma, kidney or liver disease, lung disease, cardiovascular disease, cystic fibrosis, angina, heart murmur, dizziness, shortness of breath).

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