Mount Carmel Health System

Because of You

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Stroke Risk Assessment

Each year, more than 795,000 Americans suffer a stroke. That's one stroke every 40 seconds. And with more than 137,000 deaths per year, strokes are our nation's fourth-leading cause of death.

Are you at risk for stroke?

1

Let's Start With An Easy Question...

Female
Male
2

Are you taking blood pressure lowering medications?

No
Yes
3

Systolic Blood Pressure

The first (Highest) number from your most recent blood pressure measurement.
4

Diabetes

Do you have a history of diabetes?
Yes No
5

Cigarette Smoking

Do you smoke?
Yes No
6

Cholesterol

Do you have high cholesterol?
Yes No
7

Cardiovascular Disease

Have you ever had a history of any of the following:
A history of coronary or cardiovascular disease (heart attack, chest pain, narrowed coronary blood vessels, narrowed arteries in the legs or congestive heart failure) other than stroke?
Yes No
8

Atrial Fibrillation

Do you have a history of atrial fibrillation?
Yes No
9

Physical Activity

Are you active or inactive (your job requires you to sit at a desk most of the day and you spend much of your leisure time in sitting activities [watching TV, reading, etc.])?
Active Inactive

10
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Mount Carmel Health System  |  Columbus, Ohio

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