Heart Health Assessment

Determine your heart disease risk factors by answering the questions below. Add up the numbers next to each of your answers to find your score. A score of 58-70 means you are at high risk. A score of 72 and up means your risk is very high and you should talk to your healthcare professional as soon as possible.

*1.Sex:(Required.)

Male (10)

Female (6)

*2.Age:(Required.)

Under 40 (2)

40-50 (6)

50-64 (8)

64 and over (10)

*3.Family History of Heart Disease:(Required.)

None (2)

At least one parent or sibling (10)

*4.Smoking(Required.)

Never smoked or lived with smoker (2)

Quite 15 or more years ago (2)

Never smoked but live with smoker (4)

Quit within last year (6)

Current smoker (10)

*5.Exercise (moderate intensity):(Required.)

At least 300 minutes/week (2)

At least 150 minutes/week (4)

At least 60 minutes/week (6)

Less than 60 minutes/week (10)

*6.Total Cholesterol:(Required.)

Under 200 (2)

200-239 (4)

I don't know (8)

240 and over (10)

*7.Blood Pressure:(Required.)

Normal (2)

Slightly elevated (6)

I don't know (8)

High (10)

*8.HDL/LDL Cholesterol: (Required.)

My HDL/LDL numbers are low (2)

My HDL/LDL numbers are average (4)

I don't know my HDL/LDL numbers (8)

My HDL/LDL numbers are poor (10)

*9.Body Weight: (Required.)

Healthy weight (2)

Overweight (6)

Obese (10)

*10.Diabetes: (Required.)

None (2)

Have diabetes and it's well controlled (6)

Have diabetes and it's not well controlled (10)

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