Sex:
Male Female

Age:
21-30 31-40 41-50 51-60 Over 60 

Smoking:
Never Ex-smoker Up to 10/day 10-25/day Over 25/day 

Overweight:
No 1-10 Kg 11-20 Kg 21-29 Kg Over 30 Kg 

Activity:
None Low Moderate High 

Family history of heart disease:
None Mother or father Mother & father Mother & father & sibling 

Systolic blood pressure:
111-120 121-135 136-160 161-180 Over 180 

Blood cholesterol:
Normal Slightly elevated Moderately elevated Very elevated