Section 2: Continued ...Preparing to Begin a Fitness Program

The table below provides additional information, including an indication of signs and symptoms suggestive of underlying diseases, risk factors for heart disease which, in combination, suggest the need for medical screening, and a list of conditions which may increase the risk of complications during exercise.

1: Major Signs or Symptoms which Suggest Heart, Lung or Metabolic Disease:

- Pain, discomfort, or numbness in the chest, arm, jaw, neck, or back
- Unaccustomed shortness of breath or shortness of breath with mild exertion.
- Difficult or painful breathing.
- Ankle swelling
- Palpitations or racing heart rate
- Leg pain
- Known heart murmur

If you have any of these symptoms, vigorous exercise or exercise testing (the PAT) should be postponed until medical clearance is obtained.

2: Major Heart Disease Risk Factors:

- Systolic blood pressure greater than 160 or diastolic blood pressure greater than 90 mmHg (measure on at least 2 separate occasions)
- Serum cholesterol greater than 240 mg/dl
- Cigarette smoking
- Family history of heart disease or stroke in parents or siblings prior to age 55

If you have two or more of these risk factors, vigorous exercise or exercise testing (the PAT) should be postponed until medical clearance is obtained.

3. Diabetics who:

- take insulin
- have had diabetes for more than 15 years
- who do not take insulin but are over 35 years of age

Should get medical clearance prior to beginning an exercise program.

4. It is also recommended that men over the age of 40 and women over the age of 50 have a physical exam prior to beginning a vigorous exercise program. "Vigorous" means that the amount of exercise represents a challenge and will result in fatigue within 20 minutes. Healthy persons of any age should be able to begin a low intensity exercise program without physician clearance provided that they adhere to the above conditions.

No set of guidelines can cover every conceivable situations. In general, if you know that you have a problem or disease, see your physician first. Some other conditions which indicate a need for medical screening include alcoholism, drug use or abuse, problems with dehydration or an inability to tolerate heat, and acute infections (including severe colds and flu symptoms) NEXT PAGE