ACC/AHA, ACSM and USPSTF recommendations for exercise testing before exercise training
| ACC/AHA 2002 | ACSM 2005 | USPSTF 2004 |
| Asymptomatic patients with diabetes mellitus who plan to start vigorous exercise (Class IIa) | Asymptomatic patients with diabetes mellitus (or other metabolic disease) who plan to start moderate exercise (40–59% VO2 reserve) | Recommends against routine exercise testing in low-risk adults in general and finds insufficient evidence for exercise testing before exercise training |
| Asymptomatic men >45 years and women >55 years who plan to start vigorous exercise (Class IIb) | Asymptomatic men >45 years and women >55 years or those who have >2 risk factors* who plan to start vigorous exercise |
Adapted with permission from Northcote et al27 and Thompson et al.9
ACC/AHA Class IIa indicates that the weight of evidence/opinion is in favour of usefulness/efficacy; Class IIb indicates that the usefulness/efficacy is less well established by evidence/opinion.
*Risk factors: hypercholesterolaemia, hypertension, smoking, diabetes, and a family history of premature cardiovascular disease.