A 50-year-old woman who quit smoking 5 months ago with a BP of 120/90 mmHg, a BMI of 29 kg/m2, a LDL of 135 mg/dL, and a HDL of 70 mg/dL wants to start an exercise program. How many net positive…

The three positive risk factors present are: (1) cigarette smoking - she quit within the past 6 months (threshold is cessation within 6 months); (2) hypertension - her diastolic BP of 90 mmHg meets the threshold of >=90 mmHg; and (3) dyslipidemia - her LDL of 135 mg/dL exceeds the >=130 mg/dL threshold. Her HDL of 70 mg/dL exceeds 60 mg/dL, which qualifies as one negative risk factor that is subtracted, giving a net of 3 minus 1 equals 2. Age does not apply because she is 50 and the female threshold is >=55; BMI does not apply because 29 is below the >=30 threshold.

A net of 3 would result from failing to subtract the negative risk factor conferred by her HDL of 70 mg/dL, which exceeds the 60 mg/dL protective threshold.

A net of 4 would require an additional positive risk factor such as age >=55 (she is 50) or obesity with BMI >=30 (hers is 29), neither of which is met.

A net of 5 is not supported by the data and would require counting multiple risk factors that are either absent or below the ACSM thresholds.