should i have some sort of cardiac stress test?

Hi.  I am a 45 year old female with a strong family history of heart attack and stroke by the late 40s and early 50s.  BMI 42, hbp 120/80 on Tenoretic, hdl 34 (since 2008), triglycerides between 200 and 275 (since 2006), total cholesterol around 175.  not diabetic.  only other health condition is hypothyroidism although I did have 1 parathyroid adenoma removed in July 2011.  Still trying to get TSH and free T4 under control; in process of raising Synthroid dose with my pcp (now at 112 mcg but last TSH was 17).  Vitamin D levels in the low 20's.  I lead a VERY sedentary lifestyle (I sit at a computer all day) and have not engaged in a regular exercise program.  No real cardiac symptoms.  I would like to start a serious exercise program so that I can lose weight and bring down my triglycerides and increase my hdl.  Ideally I would love to be able to someday stop taking Tenoretic!  I know it is seriously past time to get all my cardiac risk factors under control.  Would it be a good idea for me to have some sort of cardiac stress test before I start a walking and weightlifting program?  If yes, what kind?  If no, why is one not necessary?  Thanks!  Kate

[Lee Kirksey, MD]

Hello
If you have had a sedentary life and plan to exercise I would suggest having a complete evaluation by your physcian to determine if there is any detriment to doing so. Your physician will evaluate you and determine what test is necessary, perhaps just and ekg or maybe a stress depending upon your history

With this information, you will be taking your first steps towards a healthier life

Also successful management of synthroid will be helpful