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Key Industry Updates

This page features key updates to commonly cited industry guidelines and will be updated as new information is released by those organizations that set the industry standards — including the American Heart Association (AHA), American College of Sports Medicine (ACSM) and various government sources, including the U.S. Department of Agriculture (USDA) and the National Heart, Lung, and Blood Institute (NHLBI).

This is not intended to serve as a comprehensive resource. Instead, it features essential guidelines that impact the day-to-day practice of fitness professionals that may not be reflected in the latest printing of all ACE Manuals and study materials.

Health Updates

The following content was taken from key government and industry resources:

  • National Cholesterol Education Program (NCEP)
  • American Heart Association (AHA)
  • National Institutes of Health (NIH)
  • National Heart, Lung, and Blood Institute (NHLBI)
  • American College of Obstetricians and Gynecologists (ACOG)

Cholesterol and Triglycerides Classifications Based on NCEP’s 2002 Guidelines

Updates to the ACE Personal Trainer Manual 4th Edition

ATP III Classification of LDL, Total Cholesterol, and HDL Cholesterol

Note: LDL = Low-density lipoprotein; HDL = High-density lipoprotein

National Cholesterol Education Program (2002).Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Summary of the second report of NCEP Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment31 Panel III). NIH Publication No. 02-5213. Journal of the American Medical Association, 285, 2486–249


Classification of Triglycerides

Guidelines for the Identification of Metabolic Syndrome (MetS)

The AHA and the NHLBI recommend that MetS be identified as the presence of three or more of the following components (AHA/NHLBI, 2005):

  • Elevated waist circumference
    • Men >= 40 inches (102 cm)
    • Women >= 35 inches (88cm)
  • Elevated triglycerides
    • >= 150 mg/dL
  • Reduced HDL cholesterol
    • Men < 40 mg/dL
    • Women < 50 mg/dL
  • Elevated blood pressure
    • >= 130/85 mmHg
  • Elevated fasting blood glucose
    • >= 100 mg/dL

Source: American Heart Association/National Heart, Lung, and Blood Institute (2005). Scientific statement: Diagnosis and management of the metabolic syndrome. Circulation, 112, e285–e290.

Blood Pressure Classification

Classification of Blood Pressure for Adults Ag 18 and Older

* Not taking antihypertensive drugs and not acutely ill. When systolic and diastolic blood pressures fall into different categories, the higher category should be selected to classify the individual’s blood pressure status. For example, 140/82 mmHg should be classified as stage 1 hypertension, and 154/102 mmHg should be classified as stage 2 hypertension. In addition to classifying stages of hypertension on the basis of average blood pressure levels, clinicians should specify presence or absence of target organ disease and additional risk factors. This specificity is important for risk classification and treatment.

† Normal blood pressure with respect to cardiovascular risk is below 120/80 mmHg. However, unusually low readings should be evaluated for clinical significance.

‡ Based on the average of two or more readings taken at each of two or more visits after an initial screening.

Source: Chobanian, A.V. et al. (2003). JNC 7 Express: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 03-5233. Washington, D.C.: National Institutes of Health & National Heart, Lung, and Blood Institute.

Cardiopulmonary Resuscitation (CPR) Guidelines

Saving More Lives: Hands-only CPR

Interviews with people who witnessed a cardiac arrest have found that the major reason bystanders do not attempt to perform CPR is because they panic. Although more than half of the interviewees had CPR training at some time in their lives, many reported that they were afraid to cause harm or afraid they would not perform well. The fear of disease was not a factor because most were family members of the victim (Swor et al., 2006). In 2007, several AHA studies found that in some instances, CPR could be simplified to performing chest compressions only, which is referred to as “hands-only CPR” (Nagao et al., 2007; Bohm et al., 2007; Iwami et al., 2007). In this type of CPR, a bystander only needs to remember to push hard and fast on the center of the victim’s chest until trained help arrives. This is effective for victims who are adults and who have been witnessed going into cardiac arrest. When the collapse is witnessed and CPR begins immediately, the victim’s blood still contains oxygen, and oxygen remains in the lungs. By pumping the chest, this oxygenated blood can be distributed to the body. Because of its simplicity, hands-only CPR will hopefully encourage bystanders to do something—and any CPR is better than none for a victim of cardiac arrest (Sayre et al., 2008). Although it is just as effective in some circumstances, hands-only CPR does not replace traditional CPR in situations where oxygen is needed. When an adult is found unconscious (and when the blood is no longer oxygenated), and in emergencies involving infants or children, drug overdoses, drowning victims, or any adult who collapses due to a respiratory problem, a combination of breaths and compressions is needed. It is absolutely essential that fitness professionals keep their CPR provider cards current (Sayre et al., 2008). Note: Current CPR certification is required for all ACE-certified Fitness Professionals.

Building blocks of cardiopulmonary resuscitation (CPR)


Bohm, K. et al. (2007). Survival is similar after standard treatment and chest compression only in out-of-hospital bystander cardiopulmonary resuscitation. Circulation, 116, 25, 2908–2912.

Iwami T. et al. (2007). Effectiveness of bystander-initiated cardiac-only resuscitation for patients with out-of-hospital cardiac arrest. Circulation, 116, 25, 2900–2907.

Nagao, K. et al. (1999). Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): An observational study. Lancet, 369, 920–926.

Sayre, M.R. et al. (2008). Hands-only (compression-only) cardiopulmonary resuscitation: A call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: A science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation, 117, 2162–2167.

Swor, R. et al. (2006). CPR training and CPR performance: Do CPR-trained bystanders perform CPR? Academy of Emergency Medicine, 13, 6, 596–601.

Diagnostic Criteria of Diabetes Mellitus

Diagnostic criteria of Diabetes Mellitus

Contraindications and Risk Factors Associated With Pregnancy

Contraindications and Risk Factors Associated with Pregnancy

Contraindications and Risk Factors Associated with Pregnancy

Contraindications and Risk Factors Associated with Pregnancy

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