Stroke Screening Questionnaire (Stroke Risk Scorecard)
1
Blood Pressure (mmHg)
> 140/90 or unknown
120 - 139/80 - 89
< 120/80
2
Atrial Fibrillation
Irregular heartbeat
I do not know
Regular heartbeat
3
Smoking
Smoker
Trying to quit
Nonsmoker
4
Cholesterol Level (mg/dL)
> 240 or unknown
200 - 239
< 200
5
Diabetes
Yes
Borderline
No
6
Exercise
Couch potato
Some exercise (1 - 2 times/week)
Regular exercise (> 5 times/week)
7
Diet and Weight
Overweight (BMI > 25)
Slightly overweight (BMI 23.0 - 24.9)
Healthy weight (BMI 18.5 - 22.9)
8
Stroke in the family
Yes
Not sure
No
Reference: