Neurology
Stroke and Cerebrovascular Center
Risk Assessment Test
Please Answer the Following Questions:
- Have you ever been told that you have high blood pressure?
- Do you take medication for high blood pressure?
- Do you have a history of abnormal heart rate or rhythm
called atrial fibrillation?
- Have you ever been evaluated or been told you have narrowing
of the arteries to the brain?
- Have you ever had a heart attack, heart by-pass surgery,
angioplasty or another disease of the heart?
- Have you had a previous stroke, mini-stroke or TIA?
- Do you have diabetes mellitus or are you on insulin or
medication for high blood sugar?
- Have you ever smoked cigarettes?
- Do you currently smoke cigarettes?
- Has a family member had a stroke or heart attack when
they were less than 45 years of age?
- Do you consume more than two ounces of alcohol per day?
- Do you have a cholesterol level greater than 200?
- Do you smoke cigarettes and take birth control pills?
- Do you have Sickle Cell Anemia?
- Do you use one or more of the following drugs: Cocaine,
Crack, Heroin, Amphetamines?
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