My healthy heart management plan	
Date: <<Miscellaneous:Date (short)>>		
Name: <<Patient Demographics:Full Name>>	  DOB: <<Patient Demographics:DOB>>	
My risk of having a heart attack or stroke: <<My risk of having a heart attack or stroke (%)>>	
LOW RISK <5%
Less than 5 in 100 people like you, chance of having a heart attack or stroke in the next 5 years 	INTERMEDIATE RISK 5–10%
Between 5 to 10 people in 100 like you, hance of having a heart attack or stroke in the next 5 years. 	HIGH RISK ≥10%
At least 10 or more people out of 100 like you, chance of havig a heart atack or stroke in the next 5 years. 	
My risk of having a heart attack or stroke is increased because of :<<Tick the factors below that increase the risk of havi>>	
<<Smoking>> Smoking
<<Unhealthy diet>> Unhealthy diet
<<Being physically inactive>> Being physically inactive 
<<Alcohol intake>> Alcohol intake	 <<High blood pressure>>High blood pressure
<<High cholesterol>> High cholesterol
 <<Diabetes>> Diabetes
<<Chronic kidney disease>>Chronic kidney disease	 <<Family history>> Family history 
<<Other>> Other:
 	
Steps I can take to reduce my risk of a heart attack or stroke	
Medical goals	
	My current level	My goal	
Systolic blood pressure (mmHg)
	<<Blood pressure (mmHg)>>	<<My blood pressure goal (mmHg)>>	
Total cholesterol (mmol/L)	<<Total cholesterol (mmol/L)>>	<<My total cholesterol goal (mmol/L)>>	
Low density lipoprotein cholesterol (LDL-C) or 'bad cholesterol'	<<Low density lipoprotein cholesterol (LDL-C)>>	<<My LDL-C goal?>>	
New medication (if any)	
Type	Name	Dose	How to take	Notes	
Blood pressure lowering					
Cholesterol lowering					
Other					
Lifestyle goals					
	Heart Foundation goal	My goal – be specific 
(how and when)	
Smoking	Quit smoking and/or avoid second-hand smoke		
Healthy eating	Eat a heart-healthy diet: 
•	Eat plenty of vegetables, fruits and wholegrains
•	A variety of healthy protein-rich foods from animals and/or plant sources (eg legumes such as chickpeas and lentils). 
•	Choose unflavoured milk, yoghurt and cheese.
•	Include foods that contain healthy fats and oils (eg olive oil, nuts and seeds, and animal sources such as fish).
•	Use herbs and spices to flabour foods instead of salt. 
•	Avoid highly processed and discretionary (junk) food items. 
•	Restrict salt intake to reduce blood presssure, consider DASH diet 
•	Consider a Mediterranean-style diet.
•	Regular consumption of oily fish. 		
Physical activity	Engage in regular, sustainable physical activity,. Start small and aim to build up to doing 30 minutes of moderate-intensity physical activity (eg brisk walking) on most days of the week. 		
Alcohol	Drink no more than 10 standard alcoholic drinks er week and no more than 4 on any one day. 		
Weight	Achieve an maintain a healthy weight.		
Other		

Further support/referrals	
Name and contact details of health professional, service or program	What do I need to do?	

		

Heart Foundation recipes & heart healthy dinner plans 
	Visit  https://www.heartfoundation.org.au/  and search recipes	
Heart Foundation personal walking plans and walking groups 	Visit https://walking.heartfoundation.org.au/	

Plan prepared by:	
Name: <<Miscellaneous:Current User>>	
Position: <<Position of person preparing the plan (e.g. nurse, he>>	
GP's name: <<Doctor:Name>>	

My next appointment is:	My next Heart Health Check is:	
Date: <<Date of next appointment>>	Date: <<Date of next Heart Health Check>>	

Terms of use: This material has been produced by the National Heart Foundation of Australia (Heart Foundation) for the information of health professionals. The Heart Foundation does not  accept any liability, including for any loss or damage, resulting from the reliance on the content, or its accuracy, currency or completeness. Please refer to the Heart Foundation website at  www.heartfoundation.org.au for Terms of Use. 

Reproduced with permission, citing the 2023 Australian Guideline for assessing and managing cardiovascular disease risk. 
©2023 Commonwealth of Australia as represented by the Department of Health and Aged Care.