First Name
Last Name
Email
Blood Pressure
Greater than 140/90
120-139 / 80-89
Less than 120/80
Unknown
Atrial Fibrillation
Irregular heartbeat
Regular heartbeat
I don't know
Smoking
Smoker
Trying to quit
Nonsmoker
Cholesterol
Greater than 240
200-239
Less than 200
Unknown
Diabetes
Yes
Borderline
No
Physical Activity
None
1-2 times a week
3-4 times a week
Weight
Overweight
Slightly Overweight
Healthy Weight
Stroke Family History
Yes
No
Not sure
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