Body and Blood Pressure Measurement Report

Pease Study

Body Blood Pressure Report

Flesch-Kincaid Readability Score – 5.7

Attachment 21.

Pease Study

Body and Blood Pressure Measures Report

STUDY ID No.: ­­­­|_________________| NAME: |________________________________________________________________________|

DATE: |__|__|/|__|__|/|__|__| TIME: |__|__|:|__|__| AM PM STAFF INITIAL: |___________|

BODY MEASURES AND BLOOD PRESSURE ARE USEFUL TO SEE IF YOU ARE AT RISK FOR DISEASES RELATED TO HIGH BODY FAT.

ON THE BACK OF THIS REPORT --- READ MORE ABOUT WHAT YOUR MEASURES MEAN AND ACTIONS YOU SHOULD TAKE WITH A DOCTOR.

YOUR BODY MEASURES		YOUR STATUS
HEIGHT:	|__| ft |__|__| in	Body Mass Index (BMI) is calculated from height and weight. BMI and WAIST SIZE are useful for measuring body fat. They can gauge your risk for diseases that often occur with more body fat. Examples are heart disease, high blood pressure, and Type 2 diabetes.
WEIGHT:	|__|__|__| lbs
BODY MASS INDEX:	|__|__|. |__| kg/m2	BMI Below 18.5 18.5 – 24.9 25.0 – 29.9 30.0 and Above			WEIGHT STATUS Underweight Normal Overweight Obese
WAIST SIZE:	|__|__|__| in	Smaller Risk Larger Risk	WOMEN 35-in or less More than 35-in			MEN 40-in or less More than 40-in
YOUR BLOOD PRESSURE		YOUR STATUS
SYSTOLIC over DIASTOLIC	|__|__|__|/|__|__|__| mm Hg	SYSTOLIC over DIASTOLIC Less than 120 AND Less than 80 120-129 OR Less than 80 130-139 OR 80-89 140 or Higher OR 90 or Higher Higher than 180 OR Higher than 120		BLOOD PRESSURE CATEGORY Normal Elevated Hypertension Stage 1 Hypertension Stage 2 Hypertensive Crisis

PLEASE TURN OVER AND READ MORE ABOUT HOW TO USE THIS INFORMATION

WHAT YOUR WEIGHT STATUS AND WAIST SIZE MEANS	WHAT YOUR BLOOD PRESSURE STATUS MEANS
Underweight or Normal Most people who are underweight or at normal weight are not at risk for obesity-related disease. This is not a 100% surety because greater waist size, family history, or lifestyle choices still put some normal weight people at risk.	Normal Your blood pressure is normal. You should still continue to have your regular appointments and check-ups with you doctor.
Overweight Overweight people with a smaller waist size are at increased risk of disease.	Elevated Your blood pressure is slightly above normal. You should still continue to have your regular appointments and check-ups with you doctor.
Overweight Overweight people with a larger waist size are at high risk for disease.	Hypertension Notice - Hypertension Stage 1 and 2 Your blood pressure is very high. You should call your doctor and ask for an appointment. Please take this form with you and show it to your doctor. If you do not have a doctor we will help to find you one.
Obese People who are at the highest risk of disease. Please check with your doctor on how you could reduce your weight and waist size.	Hypertension Notice - Hypertension Crisis Your blood pressure is dangerously high. You cannot continue with the study. You should call you doctor right now and ask to be seen as soon as possible. Your doctor may want you to go to the emergency room instead of waiting for an appointment. Please take this form with you and show it to your doctor. If you do not have a doctor we will help to find you one.

THE NURSE HAS TO MARK WHICH CATEGORY APPLIES TO YOU BEFORE YOU LEAVE