Stroke Risk Assessment

Am I at risk for stroke?

There are many factors that can put you or a loved one at risk of having a stroke. The stroke risk assessment is a simple way to evaluate your lifestyle and determine any changes you can make to prevent a stroke from occurring. Please select Yes or No for each question.

I am a man over 45 years old or a woman over 55 years old.
My father or brother had a heart attack before age 55 or my mother or sister had one before age 65.
I have coronary artery disease, or have had a heart attack.
I have had a stroke.
I have an abnormal heartbeat.
I smoke, or live or work with people who smoke every day.
I do not know my total cholesterol or HDL levels
My total cholesterol level is 240 mg/dL or higher.
My HDL (good) cholesterol level is less than 40 mg/dL if I am a man or less than 50 mg/dL if I am a woman.
I do not know my blood pressure level.
My blood pressure is 140/90 mm Hg or higher or I have been told that my blood pressure is too high.
I accumulate less than 30 minutes of physical activity on most days of the week.
I am 20 pounds or more overweight.
I have diabetes or take medicine to control my blood sugar.
Please total each column and place numbers here. TOTAL: Yes No

If you have two (2) or more “Yes” answers, please see a healthcare professional and determine what you can do to lower your risk of stroke.

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