Question

You have a new client that wants to begin an endurance cycling program under your guidance. They start by giving you the following information while filling out their Health screening questionnaire.  

• 45 yrs old and Female
• Weighs 65 kg and is 162 cm tall
• Smoker
• Recreational cyclist (30 min of cycling 4x per week)
• No current diagnosis of cardiovascular, pulmonary or metabolic disease
• No major signs or symptoms of cardiovascular, pulmonary, or metabolic disease
• No orthopedic limitations to exercise
• Her father died of a heart attack at 65 yrs old, but her mother is still living at the age of 70.  

She also brings you a blood profile and blood pressure from a visit to a physician last week. The results are below:

• BP = 135/95 mmHg
• HDL=50 mg/dL
• LDL=149 mg/dL
• Total cholesterol = 199 mg/dL
• Fasting blood glucose = 80 mg/dL

She would like for you to assess maximal exercise capacity (VO_2max) AND begin participating in high intensity cycling in order to train for an upcoming race in 8 weeks. Answer the following: (7pts)

1. List her risk factors for CVD
2. Classify/stratify her as low, moderate or high risk for CVD
3. Can you perform a VO2 max test on her? Explain why or why not
4. Can she safely begin a high-intensity exercise training program? Explain why or why not.

Answer 1

Cardiovascular diseases comprises of group of disease of the heart and vascular system

The major conditions are

• Ischemic heart disease
• Hypertension
• Cerebrovascular disease
• Congenital heart disease
• Rheumatic heart disease

A. Risk factors

Non modifiable Risk factors	Patient Picture	Modifiable Risk factors	Patient Picture
Age - men at 45 or older, women at 55 or older Sex - women and men have equal chances Family history Genetic factors Personality	woman Family history of heart attack to his father	Cigarette smoking High blood pressure - >140/> 90 mm Hg Elevated serum Cholesterol Diabetes Obesity - BMI > 30 Sedentary habits Stress	Cigarette Smoking BMI = 24.8 HDL = 50mg/dL( should be higher than 40), LDL = 149 mg/dl ( should be less than 100), Total cholesterol = 199 mg/dl( should be between 125 - 200mg/dl) Fasting Blood glucose level - 80 mg/dl Recreational cyclist - 30 minutes 4 times per week

Other risk factors

• Genetic factors
• Physical activity
• hormones
• Type A personality
• Alcohol
• oral contraceptives
• Miscellaneous

B. Classification of risk

Risk	Status
High risk	Based on the presence of documented CVD, diabetes mellitus, end stage or chronic kidney disease, or ten year predicted risk of CAD more than 20% or CVD more than 10%
Moderate risk	Based on the presence of one or more major CVD risk factors, metabolic syndrome, evidence of subclinical vascular disease	The patient is at moderate risk for the development of CVD. He has family history and habit of smoking. She also has the BMI, and cholesterol level on the borderline.
Low risk	Absence of major CVD risk factors and engagement in a healthy life style

C. VO2 max test refers to the maximum amount of oxygen a person can utilize during exercise. It is commonly used to test the aerobic endurance or cardiovascular fitness of athletes and at the end of a training cycle.

Therefore, she should not need to perform VO2 max

D. High Intensity exercise training program is an effective training method.

It is an alternating between intense bouts of exercise and low intensity exercise.

It can be used anaerobically and aerobically with cardio

It burns more fat, improve endurance, and build strength.

Benefits of workout

1. Builds Muscle
2. Helps lose weight quickly
3. improves aerobic and anerobic capacity
4. For all over fitness

She can do the HIIT program. In order to reduce her weight and maintaining her over all fitness she can perform the program at a moderate level.