Hypertension S.M.A.R.T. Goals

HYPERTENSION S.M.A.R.T. GOALS

Name_______________________________Birthdate_____________________Date____________________

Choose one or two of these areas that you would like to work on to improve your overall health and manage your hypertension. Write down your goal(s) in the spaces provided below. To help you achieve your goals, try being “S.M.A.R.T.” Keep this in an area that is visible (ex: refrigerator, night-stand, mirror) to remind you of your goals.

Exercise Eat healthy

My goal is________________________________ My goal is_____________________________________

________________________________________ _ ____________________________________________

Check my blood pressure Lose weight

My goal is________________________________ My goal is_____________________________________

____________________________________________ __________________________________________________

Decrease stress Reduce sodium intake

My goal is________________________________ My goal is___________________________________

____________________________________________ ________________________________________________

This is how sure I am that I will be able to reach my goal: 1 2 3 4 5 6 7 8 9 10

1= not sure at all 5= somewhat sure 10= very sure

During the past month, have you often been bothered by:

Little interest or pleasure in doing things? YES NO

Feeling down, depressed or hopeless? YES NO

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