Need Medical Evaluation Before Starting Exercise Program?

According to American College of Sports Medicine guidelines, if you have risk factors for cardiovascular disease -- but not signs or symptoms -- or have no known metabolic, cardiovascular or pulmonary disease, then it is safe to start exercise at a moderate intensity.  Moderate intensity is considered comfortable enough to sustain for a prolonged time -- like 45 minutes.

Risk factors for cardiovascular disease:        
you have high cholesterol
you have high blood pressure
you smoke
are over 40 and inactive

However, if you want to participate in more vigorous exercise that would lead to exhaustion in 15-20 minutes, you must see a doctor before exercising if:
you have two or more risk factors for cardiovascular disease.
you have a metabolic disease such as diabetes.
you have pulmonary disease.
you are experiencing symptoms of cardiovascular disease such as chest
       pains, severe discomfort during physical activity or difficulty breathing
       during mild exertion such as daily living activities.

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