CHD Risk-Equivalent — Multiple CHD Risk Factors

The presence of one or more of these medical conditions may be insufficient to not certify a driver. However, the presence of these conditions can cause the driver to be at as great a risk of sudden death or incapacitation as the driver with known coronary heart disease (CHD).

CHD risk-equivalent conditions include:

• Presence of diabetes mellitus.
• Presence of peripheral vascular disease.
• A Framingham risk score predicting a 20% CHD event risk over the next 10 years.
  • Framingham Heart Study, Risk Score Profiles.
• Being over 45 years of age with multiple risk factors for CHD.

Waiting period

No recommended time frame

You should not certify the driver until etiology is confirmed and treatment has been shown to be adequate/effective, safe, and stable.

Decision

Maximum certification — 1 year

Recommend to certify if:

As the medical examiner, you believe that the nature and severity of the medical condition of the driver does not endanger the health and safety of the driver and the public.

Recommend not to certify if:

As the medical examiner, you believe that the nature and severity of the medical condition of the driver endangers the health and safety of the driver and the public.

NOTE: The decision not to medically certify a commercial driver should not depend solely on the detection of multiple risk factors.

Monitoring/Testing

The driver should obtain:

• Ongoing treating provider follow-up.
• Aggressive comprehensive risk factor management.

Follow-up

The driver should have an annual medical examination.

Commercial Drivers Without Known CHD Recommendation Table (PDF)