This is a very good question and it comes down to the risk stratification strategy that was developed through this process. The systematic reviews of the literature revealed that there generally was a higher risk for an adverse event in those individuals who possessed more than one chronic condition. Therefore, the recommendation to get more information from a physician and/or a qualified exercise professional was considered the safest and most prudent approach. In the future, as the evidence becomes more available it is foreseeable that some conditions may carry minimal additional risk when present with other conditions. However, until this information is made available we will continue with the current approach. It is important to highlight, that a qualified exercise professional plays a central role in the exercise clearance process and through his/her training will be able to determine whether further evaluation via a physician is required.