Do you have a history of heart disease*?

*Heart disease includes cardiovascular diseases

Yes No None

Are you suffering from obesity (BMI >30 kg/m2)*

*BMI is an estimate of body fat and is calculated from height and weight. Formula: weight (kg) / [height (m)]²

Yes No None

Please identify your gender

Male Female Other None

Are you aged 45 years and above?

Yes No None

Do you have high cholesterol/lipid levels?*

*Dyslipidemia- reference limits are 200 mg/dL or higher for total cholesterol (TC) and 130 mg/dL or higher for LDL-C

Yes No None

Are you on any of these following drugs* - loop diuretics, thiazides, beta-blockers, or salicylates?

• Loop diuretics : eg. Furosemide, Bumetanide, Torasemide
• Thiazide diuretics : eg.Hydrochlorothiazide, Benzthiazide, Hydroflumethiazide, Chlorthalidone, Metolazone, Xipamide, Indapamide, Clopamide
• Beta-blockers : eg.Propranolol, Metoprolol, Labetalol, Timolol, Atenolol, Carvedilol, Sotalol, Acebutolol, Celiprolol, Pindolol, Bisoprolol, Nebivolol, Esmolol
• Salicylates : eg. Aspirin

*Available from KD TRIPATHI, Essentials of Medical Pharmacology, Sixth Edition. ISBN 81-8448-085-7

Yes No None

Do you have high blood pressure?*

*ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart association task force on clinical practice guidelines. J Am Coll Cardiol, 71 (19) (2017), pp. e127-e248

Yes No None

Do you consume meat on a frequent basis?

Yes No None

Do you consume alcohol on a frequent basis?

Yes No None

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प्र1. क्या आपका हृदय रोग की बीमारी का इतिहास रहा है *?

* हृदय राेग में कार्डियाेवैस्क्युलर (हृदयवाहिनी संबंधी) बीमारियाँ शामिल हैं।

हाँ नहीं None

प्र2. क्या आप मोटापे से पीड़ित हैं (बीएमआई > ३० kg/m²)*

बीएमआई शरीर की वसा का एक अनुमान है, जिसकी गणना ऊंचाई और वज़न के आधार पर की जाती है। सूत्र: वज़न (किलोग्राम)/ऊंचाई (मीटर में ) ^२

हाँ नहीं None

प्र3. कृपया अपना लिंग पहचानें

पुरुष स्त्री अन्य None

प्र4. क्या आपकी उम्र ४५ वर्ष और उससे अधिक है?

हाँ नहीं None

प्र5. क्या आपके कोलेस्ट्रॉल/लिपिड स्तर ब़ढे हुए हैं?

*डिस्लिपिडेमिया - संदर्भ सीमाएँ टाेटल काेलेस्ट्राॅल (TC) के लिये २०० mg/dL या अधिक और LDL-C के लिये १३० mg/dL हैं।

हाँ नहीं None

प्र6. क्या आप निम्नलिखित में से कोई दवा ले रहे हैं - लूप डाययुरेटिक्स, थायज़ाइड, बीटा-ब्लॉकर या सैलिसाइलेट्स?

• लूप डाययुरेटिक्स:  जैसे फ्यूरोसेमाइड, ब्युमेटानाइड, टोरासेमाइड 
• थायज़ाइड डाययुरेटिक्स: जैसे हाइड्रोक्लोरोथायज़ाइड, बेन्ज़थायज़ाइड, हाइड्रोफ्लूमेथायज़ाइड, क्लोरथालिडोन, मेटोलोज़ोन, ज़िपामाइड, इन्डापामाइड, क्लोपामाइड 
• बीटा-ब्लॉकर्स: जैसे प्रोप्रानोलोल, मेटोप्रोलोल, लैबेटालोल, टिमोलोल, अटेनोलोल, कार्वेडिलोल, सोटालोल, असेब्यूटालोल, सेलिप्रोलोल, पिंडोलोल, बिसोप्रोलोल, नेबिवोलोल, एस्मोलोल 
• सैलिसाइलेट्स:  जैसे ऐस्पिरिन 

*Available from KD TRIPATHI, Essentials of Medical Pharmacology, Sixth Edition. ISBN 81-8448-085-7

हाँ नहीं None

प्र7. क्या आपको उच्च रक्तचाप है?*

*ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart association task force on clinical practice guidelines. J Am Coll Cardiol, 71 (19) (2017), pp. e127-e248

हाँ नहीं None

प्र8. क्या आप अक्सर मांस खाते हैं?

हाँ नहीं None

प्र9. क्या आप अक्सर शराब पीते हैं?

हाँ नहीं None

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