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| | | | Do you have high blood pressure or take medication for high blood pressure? |  |
| | Do you smoke or have a long history of smoking? |  |
| | Do you have an irregular heartbeat? |  |
| | Do you have high cholesterol or take medication for high cholesterol? |  |
| | Do you have an immediate family (parent, sibling, or child) history of stroke or heart disease? |  |
| | Do you exercise less than 3 times per week, for 20 to 30 minutes at a time? |  |
| | Do you eat a diet high in saturated and/or animal fat? |  |
| | Are you over 50 years of age? |  |
| | Are you male? |  |
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