Stroke Risk Assessment Tool

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Stroke Risk Assessment Tool

My Risk Factors

Actions I Will Take to Modify my Risk Factors

High Blood Pressure

*Normal 120/80 or less

High Blood Cholesterol

*Normal total less than 200

*HDL

greater than

50

*LDL (bad)

less than

100,

(l

ess than

70 if Diabetic)

*Triglycerides

less than

150

Smoking

Diabetes Mellitus

*Normal 70 to 140-will increase

after meals

*Admitting Blood Sugar

Overweight

(Calculate Ideal Body Weight)

*Female 5ft - 110 lb + 5 lbs for

each additional inch

*Male 5ft - 120 lb + 5 lbs for

each additional inch

*Ideal Weight

Sedentary Lifestyle

Stress & Tension

Heredity

Take your medication as prescribed

Decrease your salt intake

Follow the enclosed home walk program

Check your blood pressure daily

Take your medication as prescribed

Call 1-800-784-8669 (National Smoking

Cessation Hotline)

Take your blood sugar after meals

Follow the home walk program

Eat on a schedule: breakfast at 9AM,

Lunch at 12:30PM, dinner before 7PM

Eat fruit for snacks and cut back on sodas

Follow the home walk program

To get started while watching TV-stand up

and walk in place during commercials

Follow the home walk program

Sit in a quiet place and close your eyes

Take a deep breath through the nose and

blow it out through the mouth

Make some of the above lifestyle changes

and hope for the best!



Follow the enclosed low fat/low Cholesterol diet

Follow the enclosed walk program



Current Levels



AFIB

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Diet Plan

Your eating habits can impact your blood pressure levels. If you have high blood pressure, also known as hypertension, you will benefit from the following guidelines:

*Reduce sodium (salt) in your diet

*Increase fruits, vegetables, and potassium-rich foods *Decrease total fat, saturated fat and cholesterol in your diet

To know if prepared foods have sodium or fat, read their food label. Look for words such as salt, sodium, fat, hydrogenated or partially hydrogenated fat. Include the number of recommended servings from the fruit and vegetables groups. These foods contain potassium, a nutrient that has been shown to decrease blood pressure.

choose

Limit to 5-6 ounces per day.

• Meat, fish, poultry, shellfish, fresh or frozen, cooked without salt

• low sodium tuna or regular tuna that has been rinsed in water and drained

• tofu

• Low cholesterol egg substitutes

• Healthy Choices®_{entrees (Frozen entrees with a}

starch and vegetable should not exceed 600 mg sodium.)

• Dried beans, peas, legumes (canned beans should be rinsed and drained)

Limit to 1 serving per day.

• Ricotta cheese, part skim (½ cup) • Low sodium processed (1 oz.) • Cottage cheese (½ cup)

• Cured or processed meats: corned beef, Canadian bacon, bologna, cured ham, luncheon meats, sausage, jerky, hot dogs (regular and “1/3 less sodium’)

• Canned chicken, salmon, shrimp, sardines or meat • Peanut butter

• Textured vegetable protein (TVP) products • Frozen dinner entrees (except thoes listed under

choose

)

• Canned entrees, such as stews, chop suey, spaghetti • Processed cheeses (American, cheese spread, cheese

food)

• All other natural cheeses

Your eating habits can impact your blood pressure levels.

If you have high blood pressure, also known as hypertension, you will benefit from the following guidelines:

*Reduce sodium (salt) in your diet

*Increase fruits, vegetables, and potassium-rich foods *Decrease total fat, saturated fat and cholesterol in your diet

meats, poultry, fish, eggs, and meat substitutes

choose

Eat 4-5 servings a day.

• Canned vegetables, with no added salt • Raw vegetables

• Fresh or frozen vegetables, cooked without salt • Canned vegetables, rinse and drain before preparing (limit to 1 cup per day)

• Instant mashed potatoes, do not add salt when preparing

• Low sodium tomato or vegetable juice • Tomato sauce, no salt added

vegetables

do not choose

• Baked beans • Sauerkraut

• Pickles and pickled vegetables • Frozen seasoned vegetable dishes

• Coleslaw and potato salad, unless homemade, without salt

• Tomato or vegetable juice • Tomato sauce

• Tomato puree

This information is for educational purposes only. The contents should not replace advice from a medical professional. If you need medical assistance or have further questions, please contact your physician.

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choose

Limit to 6 servings per day. Choose whole wheat

or whole grain

• Yeast breads and rolls • Bagel (½)

• English muffin (½) • Pita (1)

• Bread dressing, homemade with no added salt (1/3 cup)

• Pancakes (1-4” diameter) • Crackers, unsalted tops (5) • Dry cereal (¾ cup) except those listed under NO LIMIT

bread, cereal, grains, and crackers

do not choose

• Refrigerated dough • Danish pastries • Toaster pastries

• Bagels with salt toppings • Biscuit mix

• Cornbread mix

• Commercially seasoned stuffing

• Hot cereal, cooked without salt • Dry cereal

Puffed rice or puffed wheat Shredded wheat

Low sodium cornflakes Low sodium crispy rice • Wheat bran or wheat germ • Crackers

Low sodium crackers Unsalted matzoh Melba toast • Tortillas

• Plain, pasta, noodles or rice

no limit

choose

• All fruits and fruit juices

• Low-sodium, salt-free vegetables

fruits and juices

Eat 4-5 servings a day. Choose high potassium

fruits such as bananas, melons, and strawberries

choose

• Milk: reduced-fat, low-fat, fat-free, chocolate, powdered, evaporated • Yogurt: low-fat or frozen

milk and yogurt

do not choose

• Buttermilk

• Instant hot chocolate/ cocoa mixes

• Malted milk

Eat 3 servings a day.

choose

• Reduced or low sodium canned soup

• Homemade soups and broth, with no added salt

• Low sodium soup bases

soups

do not choose

• All soups and broth, unless low sodium • “1/3 less salt” soups • Dehydtrated soup mixes

beverages

choose

• Coffee and tea (about 2 1/2 cups) • Carbonated beverages, low sodium • Fruit punch, lemonade

• Mineral water

do not choose

• Cocoa beverage mixes • Sport beverages

Limit caffeine to 300 mg/ day.

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choose

Limit to 1 serving per day.

• Popcorn: homemade, unsalted; microwave, unsalted

• Pretzels, unsalted • Sugar, honey • Jam or jelly

• Syrups: maple, corn, chocolate, etc. • Cranberry sauce

• Hard candy • Gelatin

• Sherbet or frozen yogurt (1/2 cup) • Popsicles

• Popcorn: commercial seasoned or microwave with salt

• Snack chips, pretzels or crackers with salt • Ice cream

• Cheesecake

• Instant pudding mixes

• Commercially prepared fudge, caramel or butterscotch toppings

snacks and sweets

do not choose

• Fat-free frozen desserts, cakes and cookies

• Low-fat (no-added sugar) ice cream

choose

• Herbs and spices without salt, (e.g., onion and garlic), horseradish powder, vinegar, Mrs. Dash®_{, Tobasco}®_sauce

• Salt, herb and spice blends containing salt • Monosodium glutamate (MSG)

Note: MSG has no taste so it is not

detected in foods! • Soy sauce • Teriyaki sauce • Steak sauce • Poultry seasoning • Relish • Barbeque sauce • Papa Dash®

condiments

do not choose

Limit:

• Mustard (1 tsp/day)

• Worcestershire sauce (1 tsp/day) • Ketchup (1 tsp/day)

choose

Limit to 6 teaspoon portions a day.

• Vegetable oils: canola, safflower, sunflower, corn, peanut, olive, soybean

• Margarine with first ingredients “liquid oil” and no trans fat

• Diet margarine • Unsalted nuts (1 oz.) • Imitation whipped topping

fats

do not choose

• Tartar sauce

• Bacon, bacon fat, “1/3 less sodium” bacon

• Gravy: canned, jarred or packet • Salt pork

• Butter

• Snack dips with instant soup mixes or processed cheese

• Olives

Limit to 1 serving per day.

• Salad dressing: regular or fat-free (1 Tbsp) • Mayonnaise: regular or fat-free (1 Tbsp) • Fat-free cream cheese

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Seasoning Your Food

• Add ¼ teaspoon dried, finely powdered, or ¾ to 1 teaspoon dried, loosely crumbled, or 1½ teaspoon fresh, chopped herbs for every four servings of food, pint of sauce, or pound of meat.

• For the best flavor, add seasoning during the last hour of cooking.

• For foods that cool in less than an hour or for salads, wet the herbs with a little oil or lemon juice and let stand for ½ hour before using to let the full flavor develop.

• For a combination of herbs and spices, use about ½ teaspoon for every four servings.

• One to two teaspoons of sugar can be added to vegetables during cooking. If a sugar substitute is used, add after foods have been cooked; the flavor can change when heated.

• If using a salt substitute, check with your doctor first. Add after foods have been cooked; the flavor can change when heated. • “Lite Salt” is still ½ salt and may need to be avoided. Salt Sense® is 1/3 less sodium.

How to add seasoning:

Beef

Pork

Fish

Eggs

Carrots

Potatoes

Rice

Broccoli

Peas (Green)

String Beans

Spinach

Corn

Caution: small amounts of herbs and spices should give the flavor you like. Too much may create a bitter or unpleasant taste.

Bay leaf, basil, dry mustard, nutmeg, green pepper, sage, onion, marjoram,

pepper, thyme, oregano, caraway, curry, garlic, parsley, rosemary

Basil, caraway, cloves, nutmeg, garlic, onion, parsley, rosemary, sage,

pepper, apples, applesauce, pineapple, allspice, oregano

Bay leaf, basil, curry, cumin, dry mustard, green pepper, lemon juice,

paprika, marjoram, onion, parsley

Basil, curry, dry mustard, green pepper, onion, paprika, parsley, nutmeg,

pepper

Parsley, honey, cinnamon, mint, lemon juice, allspice, nutmeg, caraway

seed, dill seed, ginger, thyme, pepper

Onion, basil, parsley, paprika, bay leaf, green pepper, chives, celery seed,

oregano, poppy seed, rosemary, thyme, pepper, garlic, nutmeg

Turmeric, cumin, curry, allspice, honey, onion, green pepper, pepper

Lemon juice, pepper, vinegar, basil, caraway seed, dry mustard, nutmeg,

curry, oregano, garlic

Onion, basil, mint, sage, pepper, honey, rosemary, parsley, green pepper,

oregano, garlic, poppy seed

Lemon juice, nutmeg, dill seed, thyme, vinegar, dry mustard, oregano,

caraway seed, sage, garlic, pepper

Lemon juice, vinegar, onion, allspice, basil, oregano, pepper

Green pepper, onion, paprika, pepper, curry

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Today, many restaurants provide nutrition information about their menu items. Since most fast foods and ethnic foods (Chinese, Mexican, Italian) are high in sodium, ask to see this information before making a selection. Upon request, some fast food restaurants will accommodate your needs, such as leaving the salt off your French fries, or the ketchup off your burger. Another choice is to order a salad and add a squeeze of lemon instead of dressing, which is generally high in sodium. At restaurants that prepare foods “made to order,” ask that your meal be prepared without salt of MSG.

Eating Out

Food Labels

The following are sodium labeling definitions:

Sodium Free-less than 5 milligrams of sodium per serving

Very Low Sodium-less than 35 milligrams of sodium per serving

Low Sodium-less than 140 milligrams per serving

Reduced or Less Sodium-the product has at least 25 percent less sodium than the original product

Light-a product has at least 50 percent less sodium OR 1/3 fewer calories OR 50 percent less fat than the original product

No Salt Added or No Salt-no salt has been added in the preparation of the product

*Caution: Many products with less sodium, less salt, lite, or light on the label may still have too much sodium.

Starting an Exercise Program

Exercise is very important for good health. Your healthcare provider may tell you that you need to get more exercise. To do this, you will need to get into the habit of exercising so that it becomes a part of your normal daily or weekly routine. The best exercise for you is one that you enjoy and that you will do on a regular basis. If you start a walking program, but hate to walk, you are not likely to keep it up. Find an activity that you enjoy, perhaps basketball, soccer, dance, or hiking. Try to involve family members or friends. Join a team or exercise class and make it fun.

You can get exercise at many times of the day. For example, take the stairs instead of an elevator, park far away in a parking lot and walk briskly to the store, or walk during your lunch break. The benefits are lifelong-so have fun and stick to it.

Daily Activities That Promote Exercise

• Rake leaves • Sweep the porch • Gardening

• Bike, hike, swim or dance • Vacuuming/housework

• Take the stairs instead of the elevator • Park away from building entrances and walk • Wear a pedometer to track daily activity • Walk the golf course instead of taking a cart

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Introductory Home Walk Program

Week After

Discharge

Week 1 Week 2 Week 3 Week 4 Week 5 Week6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12

Times Per Day

3 2 2 2 2 1 1 1 1 1 1 1

Allotted Time

4-5 minutes 7 minutes 15 minutes 22 minutes 30 minutes 20 minutes 25 minutes 30 minutes 35 minutes 40 minutes 35 minutes 40 minutes

Distance

400 ft to 1/8 mile ¼ mile ½ mile ¾ mile 1 mile 1 mile 1¼ mile 1½ mile 1¾ mile 2 mile 2¼ mile 2½ mile

Pace

*Leisurely Leisurely Leisurely Leisurely Leisurely *Moderate Moderate Moderate Moderate Moderate Moderate to Fast Moderate to Fast

*Leisurely pace is approximately 2 miles per hour. Moderate pace is approximately 3 miles per hour.

National Resources

American Heart/Stroke Association

www.americanheart.org, 1-888-478-7653

Centers for Disease Control and Prevention

Division for Heart Disease and Stroke Prevention

www.cdc.gov/dhdsp/state program/indes.htm

Eat Right

www.eatright.org

Shape Up America

www.shapeup.org

National Cancer Institute Smoking Cessation

www.samoefree.gov, 1-800-784-8669

Centers for Disease Control and Prevention

Stroke Prevention website www.cdc.gov/stroke

National Stroke Association

www.stroke.org, 1-800-787-6537

National Institute of Neurological

Disorders and Stroke

www.ninds.nih.gov/disorders/stroke/stroke.htm, 1-800-352-9424

National Aphasia Association

www.aphasia.org, 1-800-445-8106

National Institute of Health Stroke Webpage

http://stroke.nih.gov

Caregivers Resources

Stroke Family Warmline

(1-888-478-7653) Connects stroke survivors and their families with an American Stroke Association (ASA) trained team member who can provide support.

National Family Caregivers Association

www.thefamilycaregiver.org, 1-800-896-3650

Family Caregiver Alliance

www.caregiveer.org, 1-800-445-8106

Family Caregiver 101

www.familycaregiving101.org

Stroke Magazine or Newsletter

Stroke Connection (Subscription is free)

www.strokeassociation.org Search “stroke connection”

StrokeSmart Magazine (Subscription is free)

www.stroke.org Search “strokesmart magazine”

Online Tracking Tools

Heart360

www.Heart360.org

printable medication tracker, blood pressure tracker and weight tracker

American Heart Association

www.americanheart.org, 1800-242-8721 search for stroke tools

Salt Tracker

My Pyramid tracker

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Stroke Risk Scorecard

Risk Factors

Blood Pressure

Cholesterol

Diabetes

Smoking

Atrial Fibrillation

Diet

Exercise

I have stroke in

my family

Score (each box =1)

HIGH Risk

>

140/90 or I don’t know

>

240 or I don’t know

Yes

I still smoke

I have an irregular

heartbeat

I am overweight

I am a couch potato

Yes

Caution

120/139/80-89

200-239

Borderline

I’m trying to quit

I don’t know

I am slightly overweight

I exercise sometimes

Not sure

Low Risk

<

120/80

<

200

No

I am a non-smoker

My heartbeat is not

irregular

My weight is healthy

I exercise regularly

No

Each box that applies to you equals 1 point. Total your score at the bottom of each column and compare

with the stroke risk levels at the bottom of the page.

If your RED score is 3 or more, please ask your doctor about stroke prevention right away.

If your YELLOW score is 4-6, you are off to a good start.

Keep working at it!

If your GREEN score is 6-7, congratulations! You’re doing

very well at controlling your risk for stroke.

To Reduce Your Risk for Stroke:

1. Know your blood pressure. If high, work with your doctor to lower it.

2. Find out from your doctor if you ave atrial fibrillation. 3. If you smoke, stop.

4. If you drink alcohol, do so in moderation.

5. Find out if you have high cholesterol. If so, work with your doctor to control it.

6. If you are diabetic, follow your doctor’s recommendations to carefully control your diabetes.

7. Include exercise in the activities you enjoy in your daily routine. 8. Enjoy a lower sodium (salt) diet, lower fat diet.

9. “Ask your doctor” how you can lower your risk of stroke. 10. KNOW THE SYMPTOMS OF STROKE

If you have any stroke symptoms,

seek immediate medical attention.

*Symptoms include:

*Sudden numbness or weakness of face, arm or leg-especially on one side of the body. *Sudden confusion, trouble speaking or understanding.

*Sudden trouble seeing in one or both eyes. *Sudden trouble walking, dizziness, loss of balance or coordination.

*Sudden severe headache with no known cause.

Stroke Risk Assessment Tool