010-111 · Question #295
Mr. Garcia wishes to enroll in your exercise program. Preliminary evaluation revealed the following information: Age = 50 years Resting heart rate = 78 beats/min Weight = 198 lb (90 kg) Resting…
The correct answer is D. Hypertension, high total cholesterol, smoking, age. Mr. Garcia has four confirmed ACSM positive coronary artery disease risk factors - age (male over 45), hypertension (162/94 mmHg), high total cholesterol (240 mg/dL), and current cigarette smoking.
Question
Mr. Garcia wishes to enroll in your exercise program. Preliminary evaluation revealed the following information:
Age = 50 years Resting heart rate = 78 beats/min Weight = 198 lb (90 kg) Resting blood pressure = 162/94 mm Hg Height = 70 inches (178 cm) Body fat = 30% Blood chemistry:
Total cholesterol = 240 mg/dl (6.21 mmol/L) HDL cholesterol = 34 mg/dl (0.88 mmol/L) Triglycerides = 180 mg/dl (2.03 mmol/L) Glucose = 98 mg/dl (5.55 mmol/L) Family history and current habits:
Father died of heart attack at 90 years of age Hypertensive mother died at age 84 Smokes a pipe after dinner each evening Smokes cigarettes (25-30 per day) Reports too much work and is struggling to meet deadlines Currently doing moderate exercise No medications at present According to ACSM stratification guidelines, Mr. Garcia has which coronary artery disease risk factors?
Options
- AHypertension, obesity, high total cholesterol:HDL ratio
- BSmoking, probable diabetes, high blood pressure, age
- CSmoking, high total cholesterol, aggressive type A personality
- DHypertension, high total cholesterol, smoking, age
How the community answered
(40 responses)- A5% (2)
- B8% (3)
- C3% (1)
- D85% (34)
Why each option
Mr. Garcia has four confirmed ACSM positive coronary artery disease risk factors - age (male over 45), hypertension (162/94 mmHg), high total cholesterol (240 mg/dL), and current cigarette smoking.
This option omits smoking and age, both confirmed ACSM positive risk factors, and replaces them with the cholesterol:HDL ratio as a standalone factor rather than recognizing dyslipidemia as the composite risk category.
A fasting glucose of 98 mg/dL falls below the ACSM pre-diabetes threshold of 100 mg/dL, so 'probable diabetes' is not a valid positive risk factor for Mr. Garcia.
Type A personality is not an ACSM-recognized positive coronary artery disease risk factor, and this option omits hypertension and age, which are clearly supported by the clinical data provided.
ACSM positive risk factors confirmed in this case include age (male 50, threshold is 45+), hypertension (resting BP 162/94 mmHg exceeds the 140/90 threshold), high total cholesterol (240 mg/dL exceeds the 200 mg/dL threshold), and current cigarette smoking (25-30 cigarettes per day). HDL of 34 mg/dL is also below the 40 mg/dL threshold for men, contributing to a dyslipidemia risk factor. These four factors collectively qualify Mr. Garcia as high risk under ACSM stratification.
Concept tested: ACSM positive CAD risk factor identification and stratification
Source: https://www.acsm.org/education-resources/books/guidelines-exercise-testing-prescription
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