Heart Risk Assessment

This quiz and your results are designed to help you identify risks that may increase your chances of developing heart disease. The more risks you have, the greater your likelihood of an early heart or circulatory problem. After you read your results, visit the educational pages to learn more about reducing your risk and preventing heart disease.

1. Name
2. Address
3. Phone Number
4. Age (years)
5. Gender
Male
Female
6. Family History
Did an adult family member (parent, brother, or sister) have a heart attack or die suddenly at an early age?
Men : Before age 55
Women: Before age 65
Yes
No
7 . Personal History
Has a physician ever told you that you have had a heart attack or have angina (chest pain from inadequate circulation to the heart)?
Yes
No
8 . Stroke
Has a physician ever told you that you have had a stroke or have partially blocked blood flow to your head or legs?
Yes
No
9 . Diabetes
Has a physician ever told you that you have diabetes (abnormally high blood sugar or sugar in the urine)?
Yes
No
10 . Smoking
Do you currently smoke?
Yes
No
11 . Aerobic Exercise
How many times per week do you engage in aerobic exercise of at least 20 to 30 minutes' duration (activities such as fitness walking, cycling, jogging, swimming, aerobic dance, active sports)?
No regular exercise program
Once per week
Twice per week
Three to four times per week
Five or more times per week
12 . Dietary Saturated Fat and Cholesterol
Indicate the kind of foods that you usually eat.
High Saturated Fat Foods:
Red meats
Whole milk
Cream
Butter
Cheese		 Creamy dressings
Gravies
Fast foods
Desserts
Fried foods


Low Saturated Fat Foods:
Fish
Skinless poultry
Skim milk
Low fat dairy
Breads		 Cereals
Fruits
Vegetables
Peas
Beans


Eat high saturated fat foods most of the time
Eat high saturated fat foods often
Eat high saturated fat foods some of the time
Usually eat low saturated fat foods
13 . Blood Pressure
Indicate your usual blood pressure.
Below 130/85
130/85 - 139/89
140/90 or higher
Don't know
14 . Cholesterol
Indicate your usual blood cholesterol level.
<200 mg/dl (5.2 mmol/L)
200 - 239 mg/dl (5.2 - 6.2 mmol/L)
240 mg/dl (6.2 mmol/L) or higher
Don't know
15 . Height And Weight
Height: inches cms
Weight: pounds kgs
  Check your answers and click the button below when finished.
Your results will display below.