Which of the following conditions require immediate attention before certifying a driver?

Acute symptoms indicating a potential vascular issue require immediate attention before certifying a driver due to the serious implications such conditions can pose to both the individual's health and public safety. Vascular issues, especially when they present acutely, can lead to conditions such as heart attacks or strokes, which might incapacitate the driver unexpectedly while operating a vehicle, posing risks to themselves and others on the road.

In contrast, a regular check-up appointment or stable weight status do not indicate an immediate health concern that would affect a driver’s ability to operate a vehicle. Normal blood pressure readings, while important for overall health, do not necessitate immediate action unless they are accompanied by other concerning symptoms. Hence, any acute presentation, particularly related to vascular health, must be addressed promptly to ensure the driver is fit for duty.