Risk Stratification Case Study Practice: Joe is a Joe is a 49 year old male who
ID: 3509360 • Letter: R
Question
Risk Stratification Case Study Practice:
Joe is a Joe is a 49 year old male who stands 5’11" and weighs 240 pounds. He currently smokes one pack of cigarettes a day and indicates no history of regular physical activity over the past 10 years. He also has a sedentary occupation and travels frequently for work. His latest physical examination revealed the following information: Blood Pressure (repeated twice) – 136/88 mmHg Total cholesterol– 208 mg/dl HDL cholesterol – 41 mg/dl LDL– 134 mg/dl No medications Fasting blood glucose: 98 mg/dl Family history– Father diagnosed with CAD at age 62: Mother diagnosed with Type 2 diabetes at age 50
Positive risk factors:
Negative:
What is his risk according to ACSM guidelines?
Does he need physician approval for an exercise program?
Physician present for max?
Physician present for submax?
Explanation / Answer
The risk factors are calculated based on the ACSM risk stratification criteria.
Positive risk factors: Obesity because his BMI is 33.5kg.m-2 which is greater than or equal to 30 kg.m-2,cigarette smoking,sedentary lifestyle,age since he is greater than 45, dyslipidemia as the LDL is greater than 130mg/dl
Negative: none. hdl value is 41 mg/dl which is not greater than the expected range :60 mg/dL
What is his risk according to ACSM guidelines? Moderate risk based on the positive risk factors stated above.Asymptomatic because 2 risk factors
Does he need physician approval for an exercise program?
Joe is on moderate risk with >2 CVD risk factors so before starting a vigorous intensity physical activity program he should be encouraged to consult with a physician
For light to moderate intensity physical activity programs like walking he can start without the consent of a physician
Physician present for max? Physician supervision of exercise testing is for not recommended for moderate risk
Physician present for submax? Not recommended