About Heart Care -

Cardiovascular Risk Assessment
This is a tool designed by the staff of HeartCare. It is based on our long experience in seeing a wide variety of patients with metabolic and/or genetic predisposition to diseases of the cardiovascular system. Therefore, although the following questions cover common risk factors, it is also their interrelationship that is significant, and we have quantified risk and test scoring based on our analysis.

If you do not know your current levels of cholesterol, both HDL and LDL, and your triglycerides, we strongly advise you to obtain those numbers before proceeding, as the test is especially sensitive to that data. Similarly, if you are unclear about your family history, the test becomes much less accurate. If you have questions or concerns, you are advised to consult with a cardiologist experienced in advanced lipid testing. You may also email us at help@aboutheartcare.com and we will be happy to help.

Name: Date:

1.	Gender:	Male
		Female

2.	Age:		Male	Female
		<20
		20-29
		30-39
		40-49
		50-59
		60-69
		>70

3.	Answer only one of the following:	Yes	No
	a) Are you slightly overweight?
	b) Are you moderately overweight?
	c) Are you extremely overweight?

4.	Do you excercise regularly?
	(averaging 3 times per week)

5.	Do you excercise regularly?
	(averaging 5 times per week)

Are you watching your diet in terms of fat content?

Do you have a sweet tooth?

Do you smoke?

Do you smoke one pack a day or more?

10.

Do you drink alcohol on a regular basis?

11.

Are you a heavy drinker?

12.

Do you have or are you currently being treated for high blood pressure?

13.

Do you have or are you currently being treated for diabetes?

14.

Do you have a history of heart attack?

15.

Do you have a history of stroke?

16.

Do you have any first-degree blood relative with a heart attack?

17.

Do you have any first-degree blood relative with stroke?

18.

Do you have any first-degree blood relative with diabetes?

19.

Do you have any first-degree blood relative with high cholesterol?

20.

Do you consider your stress level:

none slight moderate severe

21.	What is your cholesterol level?		Male	Female
	(total cholesterol, HDL, LDL, triglyceride)
		Total cholesterol is < 200
		Total cholesterol is > 200

22.	What is your HDL level?		Male	Female
		HDL is < 40
		HDL is 40-50
		HDL is > 50

23.	What is your LDL level?
		< 100

		100 - 300
		If answer 'Yes' to question #14 or #15.
		If answer 'No' to question #14 or #15.

		130 - 160
		If answer 'Yes' to question #14 or #15.
		If answer 'No' to question #14 or #15.

		> 160
		If answer 'Yes' to question #14 or #15.
		If answer 'No' to question #14 or #15.

24.	What is your Triglyceride level?		Male	Female
		Triglyceride is < 150
		Triglyceride is > 150

This is your score:

≤ 7	Low Risk
8 - 12	Moderate Risk
≥ 13	High Risk

Low Risk:		Congratulations! Take the test again periodically, and stay on your course to good health. Annual physical exams, especially when you are 50 and beyond, are a good idea. Family history is an indicator that earlier annual testing may be indicated.

Moderate Risk:		You have some risk factors that bear watching. Consider asking your doctor about getting a lipid panel performed periodically to monitor your progress, and modify your lifestyle in the direction of good health, watching your diet, exercise, stress levels, and getting periodic physical exams. Consider advanced blood testing to see if your genetic or metabolic factors require individualized diet or medication.

High Risk:		You probably already have a good idea about what needs to be changed in general, although if you are in this category, you may want to consider advanced lipid testing to uncover your precise blood chemistry. This could be determinative insofar as diet and medications are concerned. (For example, for some patients, a very low fat diet can actually worsen your tendency toward atherosclerosis!) CT heart scans and cartoid artery ultrasounds are helpful in revealing the extent and location of calcified plaque in your cardiovascular system. You need active, preventive measures to stabilize and reverse your path, as risk increases with age.