Mr.

Mr. Smith 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. Smith has which of the following coronary artery disease risk factors?