

| Stroke Risk Evaluation Many strokes can be prevented. Complete this form and discuss the results with your health care provider to determine the best methods to reduce your stroke risk. Uncontrollable Risk Factors Are you over age 55? Yes No The chances of having a stroke go up with age. Two-thirds of all strokes happen to people over age 65. Stroke risk doubles with each decade past age 55. Does your family have a history of stroke? Yes No Although actual risk varies, people with a family history of stroke are at risk for stroke themselves. Do you have diabetes? Yes No People with diabetes have a high stroke risk. This may be due to circulation problems resulting from diabetes. You can manage this risk factor for stroke by following your doctors recommendations to control your diabetes. Are you of African-American or Hispanic decent? Yes No African Americans and some Hispanics have two to three times the stork risk of most other racial groups. This may be due to diet, a great incidence and severity of high blood pressure and diabetes. Having one or more uncontrollable risk factors does not necessarily mean you will have a stroke. It does not mean that you should pay special attention to lifestyle factors and treatable medical disorders to reduce overall risk. Controllable Risk Factors: Lifestyle Do you smoke? Yes No Smoking doubles your risk for stroke. It speeds up hardening of your arteries, increases the chance for blood clots to form and raises your blood pressure. If you quit smoking today, your stroke risk from this factor may decrease significantly. Do you consume more than two alcoholic beverages a day? Yes No Drinking more than two drinks per day may increase your risk for stroke by as much as three times. Since alcohol is a drug which can interact with medication you are taking, discuss alcohol consumption with your doctor. If you dont drink, dont start. Are you overweight? Yes No Excess weight can contribute to other stroke risk factors such as high cholesterol, high blood pressure and diabetes. Your doctor can recommend a weight reduction program that includes changes in diet and physical activity. By adopting a healthy lifestyle, you can significantly decrease your risk for stroke. Controllable Risk Factors: Medical Conditions Is your blood pressure consistently higher than 135/85? Yes No Having high blood pressure (hypertension) makes you four to six times more likely to have a stroke. It is the single most controllable stroke risk factor. Hypertension affects approximately 50 million American adults or about one-third of the population. Your doctor may recommend treating your condition with a combination of the following: a low salt diet, losing weight, stopping smoking, enjoying exercise and taking medication. Do you have an irregular heartbeat? Yes No Atrial fibrillation, also known as AF, is a particular type if irregular heartbeat that affects more than 1 million Americans. AF can increase your stroke risk four to six times. It can be treated by cadioversion, a procedure in which an electrical stimulus is used to restore your hearts normal rhythm. When this does not work treatment concentrates on preventing the formation of blood clots. This is done with medication. Is your cholesterol level more than 200? Yes No High cholesterol is an indirect risk factor for stroke because it can put you at greater risk for heart disease. A cholesterol level of more than 200 is considered high. If you dont know what your cholesterol level is, find out. If you do have high cholesterol, work with your doctor to develop a plan to lower it. Though most people can control their cholesterol levels through diet and exercise, some cannot and need medication prescribed by their physicians. Have you already had a TIA or stroke? Yes No Transient Ischemic Attacks (TIAs or mini-stroke) are brief episodes of stroke symptoms that usually last only a few minutes. Unlike stroke, TIAs do not result in brain damage. TIAS should never be ignored! More than one-third of all people who experience TIAs will go on to have a stroke. If you already had a stroke, you may be up to 10 times more likely to have another. |