RFP 25084 Attachment 1 ACSM Coronary.pdf
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- Solicitation number
- 85898
- Issued by
- Williamsburg City, Virginia
About this file
This is Attachment 1 of RFP 25084, which details the American College of Sports Medicine (ACSM) Coronary Artery Disease Risk Factor Thresholds and risk stratification guidelines. The document outlines a scoring system for cardiovascular risk factors including family history, smoking, hypertension, dyslipidemia, impaired fasting glucose, obesity, and sedentary lifestyle. It also provides clear definitions for categorizing individuals into low, moderate, and high-risk groups based on age, gender, and number of risk factors present.
The document includes a comprehensive matrix of ACSM recommendations for medical examinations and exercise testing requirements based on risk level and exercise intensity. For low-risk individuals, most tests and examinations are deemed "Not Necessary," while high-risk individuals require recommended medical examinations and physician supervision for both moderate (40-60% VO2max) and vigorous (>60% VO2max) exercise, as well as submaximal and maximal testing. The document serves as a clinical reference guide for healthcare providers to assess and stratify patients' cardiovascular risk levels and determine appropriate pre-exercise screening requirements.
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ATTACHMENT 1
ACSM Coronary Artery Disease Risk Factor Thresholds Risk Factors Defining Criteria Score
Family history MI, coronary revascularization, or sudden death in an immediate +1 relative (male <55 years or female <65 years)
Cigarette Smoking Current smoker or those who quit within the past 6 months +1 Hypertension SBP ≥140 mmHg or DBP ≥90 mmHg confirmed by +1 measurements on at least two separate occasions, or on antihypertensive medication
Dyslipidemia Total >200 mg/dL or HDL <40 mg/dL or LDL >130 mg/dL; if +1 LDL >130 mg/dL, use LDL rather than total >200 mg/dL, or on lipid-lowering medication
Impaired Fasting Glucose Fasting blood glucose ≥ 100 mg/dL confirmed on two separate +1 occasions
Obesity BMI >30, or waist girth >102 cm (40 in) for men and > 88 cm +1 (35 in) for women, or waist-to-hip ratio ≥ 0.95 for men and ≥
0.86 for women
Sedentary Lifestyle Persons not participating in a regular exercise program or +1 accumulating 30 minutes or more of moderate physical activity on most days of the week
High Serum HDL >60 mg/dL 1
SCORE
Initial ACSM Risk Stratification Low Risk (younger)
Men <45 years of age AND no more than one positive risk factor Women <55 years of age AND no more than one positive risk factor Moderate Risk (older)
Men 45 or older Women 55 or older Those who meet the threshold for two or more positive risk factors
High Risk Cardiac, peripheral vascular, or cerebrovascular disease Chronic OPD, asthma, interstitial lung disease, or cystic fibrosis Diabetes mellitus type 1 or 2, thyroid disorders, renal, or liver disease
Those with one or more of the following signs or symptoms:
Angina Ankle edema Shortness of breath at rest or with mild exertion Palpitations or tachycardia Dizziness or syncope Orthopnea or paroxysmal nocturnal dyspnea Unusual fatigue or shortness of breath with usual activities
Intermittent claudication Known heart murmur
ACSM Recommendations for (A) Current Medical Examination and Exercise Testing Prior to Participation and (B) Physician Supervision of Exercise Tests
Low Risk Moderate Risk High Risk A.
Moderate Exercise (40–60% VO2max) Vigorous Exercise (>60% VO2max) B.
Not Necessary Not Necessary Recommended
Not Necessary Recommended Recommended
Submaximal Test Not Necessary Not Necessary Recommended Maximal Test Not Necessary Recommended Recommended
| Risk Factors Defining Criteria Score |
| SCORE |
| Low Risk Moderate Risk High Risk |
| B. |
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