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Complete the questionnaire to the best of your ability and hand it in with your Medicare pharmacist to find out the health of your heart.

Gender 1Male1 out of 2 men will develop heart disease by age 40. 2
Female1 out of 3 women will develop heart disease by age 40. 2
Age 1Male over 45 years 3The older you are, the higher your risk of heart disease. 4
Female over 55 3
Family history 1,3Male before 55 3If there is a history of heart disease in your family, then the greater your risk becomes. 3
Female before 65 3
High blood pressure 1,5YesYou will have a 2-3 times higher risk of heart disease if your blood pressure is high. 5
Don’t know*
High cholesterol 6YesIt is important to know what your cholesterol is. The higher your cholesterol, the higher your risk of heart disease.6
Don’t know*
Diabetes 7YesBeing a diabetic or having a high blood sugar level, doubles your risk of developing heart disease. 7
Don’t know*
Not physically active 8YesYour chances of developing heart disease is 1½ times higher if you are not physically active 8
Overweight 2YesIf you are overweight or obese, you have a two times higher risk of developing heart disease.2
Don’t know*
 Waist measurement 7,9YesThe bigger your waistline, the higher your risk of heart disease 7,9

  • In men, bigger than 94 cm (37”)
  • In women, bigger than 80 cm (31”)
Don’t know* 
Smoking 7YesSmoking doubles your risk of heart disease and stroke. 7
Unhealthy diet 7YesAn increase of only 2 % in trans fatty acids, increases your heart attack risk by 23 %. 7
Stress 10YesIf you are stressed, you will have a 10-40 % higher risk of heart disease. 10
Alcohol 7YesThe more you drink, the higher your risk of heart disease. 7

Don’t Know?

If you don’t know, then let our friendly Medicare pharmacist or professional nurse help you determine these measurements or levels. Let us help you take better care of your heart and health.

References: 1. Li YQ, Wright SCD. Risk factors for cardiovascular disease in the Ga-Rankuwa community. Curationis 2007;30(4):79-87. 2. Roeters van Lennep JE, Westerveld HT, Erkelens DW, van der Wall EE. Risk factors for coronary heart disease: implications of gender. Cardiovasc Res 2002;53:538-549. 3. Boudi FB, Ahsan CH. Risk Factors for Coronary Artery Disease. [Online] 2016 Nov 27 [cited 2017 Dec 19]. Available from: URL: 4. Jousilahti P, Vartiainen E, Tuomilehto J, Puska P. Sex, Age, Cardiovascular Risk Factors, and Coronary Heart Disease: A Prospective Follow-Up Study of 14 786 Middle-Aged Men and Women in Finland. Circ 1999;99:1165-1172. 5. Kannel WB. Blood Pressure as a Cardiovascular Risk Factor: Prevention and Treatment. JAMA 1996;275(20):1571-1576. 6. The Heart and Stroke Foundation South Africa. What is cholesterol? [online] [cited 2017 Dec 19]. Available from: URL: 7. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J 2016;37:2315-2381. 8. World Health Organization. Risk factor: physical inactivity. [Online] [cited 2018 Jan 11]. Available from: URL: 9. Flint AJ, Rexrode KM, Hu FB, Glynn RJ, Caspard H, Manson JE, et al. Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women. Obes Res Clin Pract 2010;4(3):e171-e181. 10. Kivimäki M, Kawachi I. Work Stress as a Risk Factor for Cardiovascular Disease. Curr Cardiol Rep 2015;17:74.

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