Campus Alert: Find the latest UMMS campus news and resources at umassmed.edu/coronavirus

Page Menu

Question 2

Which TWO of the following individuals are most likely to have a stroke in the next 1-2 years?

a. Anne, a 45 year-old white woman whose past medical history is unremarkable. She is a non-smoker and has a total cholesterol of 190 mg/dL (HDL 70; LDL 120); her blood pressure is 110/80 mm Hg. She teaches aerobics at the local gym and encourages her students to follow healthy diets. Both her parents are alive and still active in community affairs; her mother has recently completed treatment for breast cancer.
b. Anne's father Henry, a 68 year-old white man who had what he calls a "mini-stroke" 3 years ago. His doctor found that his left carotid artery in his neck was nearly blocked, and he underwent carotid endarterectomy (surgical removal of the obstructing atherosclerotic plaque). Since then he has been very conscientious about carrying out his doctor's recommendations: following a low-fat diet that contains many fruits and vegetables, losing 20 pounds, walking 2 miles most days, and taking both blood pressure medications and a statin (a cholesterol-lowering agent).
c. George, a 45 year-old African American high school science teacher diagnosed with high blood pressure 2 years ago. Initially George took his prescribed blood pressure medications erratically. However, when a close friend suffered a heart attack and nearly died, George began taking his medicine regularly. For the past year, his blood pressure has been less than 130/85 mm Hg. George helps coach the basketball team, and stays in shape by participating in defensive drills and lifting weights. He is a non-smoker who tries to discourage members of his team from smoking. Recently, George decided to cut out some of the fatty fried foods he loves to eat, although he confesses that when he and his wife go to his mother's house for holidays he indulges. His father died following a massive heart attack at age 53.
d. George's mother Sally, a 68 year-old african american woman who hadn't been to a doctor in years but recently went to her local health clinic at her son's urging. At the clinic, Sally's BMI (body mass index) was determined to be 35, putting her in the "obese" category, and repeated blood glucose tests indicated that she was diabetic. Her blood pressure was 170/90 mm Hg on her first visit, and 160/90 on her second visit. Her total cholesterol was 260 mg/dL. Sally isn't particularly concerned about her health, declaring that her son worries too much about her and that she feels pretty good for someone her age. She is especially proud of the fact that she has never smoked, and that she made sure George never did either. 

Answer to Question 2

Correct Answer:

b. Anne's father Henry , a 68 year-old White man

d. George's mother Sally, a 68 year-old African American woman

Additional Information:

b. Anne's father Henry

  • Previous TIA (a major Risk Factor because this demonstrates that significant vascular pathology is always present)
  • History of atherosclerosis (symptomatic carotid stenosis treated surgically)
  • Hypertension (controlled by medication)

d. George's mother Sally

  • Race (African-American)
  • Obesity (BMI >30)
  • Diabetes
  • Hypertension (not controlled by medication)
  • High cholesterol (not controlled by medication)