___I smoke 1 to 2 packs per day ___I smoke 2 or more packs per day
___I quit smoking ___I inhale ___I do not inhale ___I smoke cigars
___I smoke a pipe ___I am exposed to second hand smoke
___How many years have you smoked?____
___I have quit smoking in the last 5 years.
Have you ever had a total cholesterol test? __Yes __No
Date of last cholesterol test_____
Is your total cholesterol greater than 200? __ Yes __No
Is your LDL cholesterol level higher than 100 mg/dl? __Yes __No
Is your HDL cholesterol level lower than 40 mg/dl? __Yes __No
Is your triglyceride level greater than 150? __Yes __No
Do you have Diabetes? __Yes __No
Would you describe the daily exercise you get as ‘minimal or none’? __Yes __No
Are you overweight? __Yes __No
What is your weight in pounds?____
For a man: Does your waist at your belly button measure more than 37 inches? __Yes __No
For a woman: Does your waist at your belly button measure more than 35 inches? __Yes __No
What is your height in inches?_____
Are you subject to unusual stress? __Yes __No
Do you drink more than two drinks a day? __Yes __ No
Did your grandfather, father, or brother have heart trouble or a heart attack before age 55? __Yes __No
Did your grandmother, mother, or sister have heart trouble or a heart attack before age 65? __Yes __No
Have you ever had any of the following blood tests: homocysteine, CRP, or fibrinogen? __Yes __No
You have taken your first risk factor analysis in this book. You will take more as you continue. When you finish, you should bring this information to your physician for his or her analysis.
You must be proactive as regards your health. This is crucial. Your physician may not be able to take the time to assess you completely in this way. Help him or her by identifying all your risk factors. Then together you both can decide what positive risk factors demand corrective action or specific therapy. Again, I repeat, early disease detection and prevention is the name of the game, and it can’t be done without a risk factor analysis—and a thorough and complete medical examination (the subject of my previous book: The Patient’s Guide to the Complete Medical Examination and the Prevention of Medical Errors—(see appendix 1.)
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