High Cholesterol Questionnaire

Step into a journey of better health with our High Cholesterol Questionnaire. Elevated cholesterol levels can pose serious risks to your cardiovascular well-being, potentially leading to heart disease and strokes. Complete this questionnaire to gain valuable insights into your cholesterol profile and take your next steps towards unlocking personalised recommendations tailored to your needs.

Before you begin the assessment, please note that this questionnaire is intended for initial screening purposes only. It is not a substitute for professional medical advice or diagnosis. If you have any concerns about your health or cholesterol levels, we strongly recommend consulting with a healthcare professional for a comprehensive evaluation.

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Result

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1. Are you Male or Female? *

• Male
• Female

2. What is your age range? *

• Below 20
• 21-30
• 31-40
• 41-50
• 51-60
• 60+

3. Do you have a family history of heart disease? *

• No, there is no family history.
• Yes, one immediate family member has a history of heart disease.
• Yes, multiple immediate family members have a history of heart disease.

4. Do you have a family history of stroke? *

• No, there is no family history.
• Yes, one immediate family member has a history of stroke.
• Yes, multiple immediate family members have a history of stroke.

5. Have you been diagnosed with high cholesterol in blood tests? (Total cholesterol > 250mg/dl or 8.5mmol/L) *

• No, my cholesterol levels are within the normal range.
• Yes, my blood tests have shown high cholesterol levels.
• I am unsure/I have not done a blood test.

6. Are you currently taking medications known to affect cholesterol levels? (e.g., statins, corticosteroids) *

• No, I am not taking any medications that affect cholesterol levels.
• Yes, I am taking medications that may impact cholesterol levels.

7. Have you experienced any chest pain or discomfort? *

• No, I have not experienced any chest pain or discomfort.
• Yes, I have experienced occasional chest pain or discomfort.
• Yes, I have frequent or persistent chest pain or discomfort.

8. Have you noticed any difficulty in breathing or shortness of breath? *

• No, I have not experienced any difficulty in breathing or shortness of breath.
• Yes, I have experienced occasional shortness of breath during strenuous activity.
• Yes, I experience shortness of breath even with minimal physical exertion.

9. How often do you engage in exercise per week (at least 30 minutes)? *

• More than three times a week.
• Once or twice a week.
• Rarely or never.

10. How often do you consume a portion of carbohydrates (noodles, rice, bread, or pasta) in a day? *

• Once a day or less.
• Twice a day.
• Three times a day or more.

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You’ll get your results soon! Please provide an email address to receive a digital copy of your results for convenient reference during future doctor visits.

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