Are You at Risk?

Are you at risk for cardiovascular problems?  Take our short survey to find out. 

    AGE & SEX
        Yes   No      I am older than 45 years and a man.
        Yes   No      I am older than 55 and a woman.
     
    FAMILY
        Yes   No      My father or brother had a heart attack before age 55.
        Yes   No      My mother or sister had a heart attack before age 65.

    BLOOD PRESSURE  Learn more
        Yes   No      My blood pressure is 140/90 or higher.
        Yes   No      A doctor or nurse has told me my blood pressure is too high.
        Yes   No      I don't know what my blood pressure is.

    SMOKING  Learn more
        Yes   No      I am a smoker.

    CHOLESTEROL  Learn more
        Yes   No      My total cholesterol is 200 mg/dL or higher.
        Yes   No      My HDL cholesterol is less than 40 mg/dL.
        Yes   No      I don't know my cholesterol levels.

    EXERCISE & WEIGHT
        Yes   No      Most days, I get less than a total of 30 minutes of physical activity.
        Yes   No      I have a BMI (Body Mass Index) of more than 25.

    MEDICAL HISTORY
        Yes   No      I have diabetes.  Learn more
        Yes   No      I use medicine to control my blood sugar.
        Yes   No      I have a fasting blood sugar level of 126 mg/dL or higher.
        Yes   No      I have had angina (chest pains) or a heart attack.

If you answer "yes" to any of the questions above, print and take this form to your next doctor's appointment. It's time to start learning how to reduce or control the risks that may be in your body or your lifestyle.

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More information
If you know your cholesterol levels, you can calculate your risk of having a heart attack in the next 10 years.

• Take the National Institutes of Health Heart Attack Risk Survey
  (The survey will open in a new browser window.)