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Metabolic Syndrome Worksheet

To help manage your condition, fill in the dates on which you had or will have the following tests or checkups.

Lipid profile

I had a lipid profile on __________. A lipid profile is a lab test that measures the amount of certain fats and cholesterol in your blood. High lipid levels can lead to a heart attack or cause your heart disease to worsen. You should have a lipid profile at least once a year.

Generally, your LDL ("bad") cholesterol should be less than 100 mg/dL, and your triglycerides (also "bad") should be less than 150 mg/dL. Your HDL ("good") cholesterol should be greater than 40 mg/dL for men and greater than 50 mg/dL for women. Talk with your provider about helping you meet your goals.

Blood pressure

My blood pressure is __________. High blood pressure can lead to serious health problems. Blood pressure-lowering medications along with lifestyle changes can achieve the best results. The American Heart Association recommends a blood pressure of less than 120/80 mm Hg. The American Diabetes Association recommends a blood pressure of less than 130/80 mm Hg for people with renal disease or diabetes. Make sure that your blood pressure is checked at every time you visit your health care provider.


I talked with my provider about quitting smoking on __________. If you smoke, quit. Cigarette smoking is a strong risk factor for heart disease. As soon as you quit, your blood vessels begin to return to normal.

Blood sugar

I had my blood sugar checked on __________. Have your blood sugar checked at regular intervals as recommended by your doctor. Early detection and treatment of high blood sugar will help prevent diabetes or delay the progression of diabetes for people with diabetes.

Weight management

I talked with my provider about how to manage my weight on __________. Losing just 5 to 10 percent of your weight or 2 inches from your waist can make you healthier. It's better to lose a small amount of weight and keep it off than to lose a lot of weight fast and gain it back.


I talked with my provider about medications to help lower my risk for heart disease on __________. Several medications can help treat or prevent heart disease in many people.