Bill is a 50-year-old man with a family history of heart disease. His body mass index is 20 and he has been running 3 miles 3-4 days a week for a year. What are the exercise testing recommendations according to risk stratification based on his cardiovascular disease risk factors? - Moderate risk, medical exam necessary before vigorous exercise. Although Bill is at a higher than average fitness level for his age, because he is over 45 years old and has a family history of heart disease, he has 2 points on the risk factor scale, therefore requiring a medical exam before any vigorous exercise is initiated.