Risk Factors (Positive)

ACSM Coronary Artery Disease
Risk Factor Thresholds
ACSM Coronary Artery Disease Risk Factor Thresholds will be used to identify a client that
requires further evaluation by a physician. This table shall be reviewed with the information
provided by the client on the Health History Form. Clients having 2 or more positive risk
factors are required to be evaluated and cleared by a physician prior to having a fitness
evaluation or being given a fitness program. Clients shall subtract a risk factor if the have
the negative risk factor of HDL cholesterol >60 mg/dl.
Risk Factors (Positive)
Family History
Cigarette Smoking
Impaired Fasting Glucose
Sedentary Lifestyle
Risk Factor (Negative)
High Serum HDL cholesterol
Defining Criteria
Myocardial infarction, coronary revascularization,
or sudden death before 55 years of age in father
or other male first-degree relative (i.e. brother or
son), or before 65 years of age in mother or other
female first-degree relative (i.e. sister or
Current cigarette smoker or those who quit within
the previous six months
Systolic blood pressure of >140 mmHg or
diastolic >90 mmHg, confirmed by
measurements on at least two separate
occasions, or on antihypertensive medication.
Total serum cholesterol of >200 mg/dL or HDL
or, 40 mg/dL, or on lipid-lowering medication. If
LDL is available, use >130 mg/dL rather than
total cholesterol of >200 mg/dL.
Fasting blood glucose of >110 mg/dL confirmed
by measurements on at least two separate
Body mass index of >30 kg/m2, or waist girth of
>40 inches (102 cm) in men and >35 inches (89
cm) in women.
Persons not participating in a regular exercise
program or meeting the minimal physical activity
recommendations from the US Surgeon
General’s report.
>60 mg/dL
In addition, ACSM recommends that males over age 45 and females over age 55 have a
medical evaluation, including a maximal exercise test, before beginning vigorous exercise
programs. If low to moderate exercise is the goal, only those persons diagnosed with
cardiopulmonary disease, or those with one or more major signs or symptoms suggestive
or cardiopulmonary disease, need to have a medical examination and clinical exercise test
prior to beginning an exercise program.