010-111 · Question #158
Your client is a 59 year old sedentary female with a body mass index of 33 kg/m2. She has no history of heart disease herself, but her mother had a myocardial infarction at the age of 66. She is an…
The correct answer is B. Obesity, sedentary lifestyle, hypercholesterolemia. The three ACSM-defined positive CAD risk factors present are obesity, sedentary lifestyle, and dyslipidemia (low HDL of 30 mg/dL); the other answer options either include factors the client does not possess or omit one of the confirmed factors.
Question
Your client is a 59 year old sedentary female with a body mass index of 33 kg/m2. She has no history of heart disease herself, but her mother had a myocardial infarction at the age of 66. She is an ex- smoker who quit 15 years ago, blood pressure is consistently 135/85 mm Hg, total cholesterol is 180 mg/dL (4.6 mmol/L) with an HDL level of 30 mg/dL (0.8 mmol/L), and blood glucose is 100 mg/dL (5.6 mmol/L). She has come to you for advice because she wishes to improve her overall health and fitness. What are the risk factors according to the American College of Sports Medicine?
Options
- AFamily history, cigarette smoking
- BObesity, sedentary lifestyle, hypercholesterolemia
- CHypercholesterolemia, impaired fasting glucose, obesity, hypertension
- DFamily history, obesity, sedentary lifestyle, hypertension, cigarette smoking
How the community answered
(46 responses)- A2% (1)
- B78% (36)
- C7% (3)
- D13% (6)
Why each option
The three ACSM-defined positive CAD risk factors present are obesity, sedentary lifestyle, and dyslipidemia (low HDL of 30 mg/dL); the other answer options either include factors the client does not possess or omit one of the confirmed factors.
Family history requires a first-degree female relative with CVD before age 65 - the mother's MI at age 66 does not qualify - and cigarette smoking requires current use or cessation within 6 months, not 15 years prior.
Obesity (BMI 33 kg/m2 meeting the ≥30 threshold), physical inactivity (sedentary with no regular exercise program), and dyslipidemia labeled as hypercholesterolemia (HDL 30 mg/dL below the <40 mg/dL threshold) are the three verified positive ACSM risk factors. Family history does not qualify because the mother's MI occurred at age 66, which is not before the age-65 cutoff for female first-degree relatives, and smoking cessation 15 years ago does not meet the within-6-months criterion.
Hypertension requires BP ≥140 mmHg systolic or ≥90 mmHg diastolic (her BP of 135/85 does not meet this threshold), and impaired fasting glucose requires confirmation on two separate occasions, which is not established here.
Family history (mother's MI at 66, above the <65 threshold), hypertension (135/85 is below the ≥140/90 threshold), and cigarette smoking (cessation 15 years ago, beyond the 6-month window) all fail to meet their ACSM positive risk factor criteria.
Concept tested: Identifying specific ACSM CAD positive risk factors by threshold
Source: https://www.acsm.org/education-resources/books/guidelines-exercise-testing-prescription
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