Physical activity:

301

Do you do physical activities? 1. YES |__| NO|__|

What duration? <30 mins |__| 30 m - 1 h |__| 1 h - 1 h 30 |__| >2 h |__|

|__|

302

At what frequency?

1. Once/week|__| 2. Twice/week|__| 3. Trice/week |__| 4. Daily |__|

|__|

303

What level of physical activity do you do during your leisure time? 1. Mild |__| 2. Moderate |__| 3. High|__|

|__|

Drug history

401

When did you start taking medications for Rheumatoid arthritis?

402

Which of the following medications do you take?

1. Methotrexate |__| 2. Aziathropine |__| 3. Cyclosporine |__| D-Penicillamine |__| 4. Sulfasalazine |__| 5. Hydroxychloroquine |__| 6. Minocycline|__| 7. Leflunomide|__| 8. Infliximab |__| 9. Etanercept |__| 10. Corticosteroid |__| 11. NSAIDs|__|

|__|

403

Are there other medications you take routinely? Yes |__| No |__| if yes please state them

|__|

Disease Activity Score (DAS) |__|

404

Number of tender joints: Number of swollen joints: CRP/ESR: Patient global health/10

SECTION III: ANTHROPOMETRIC AND BLOOD PRESSURE MEASUREMENTS

501

Weight …………kg; Height…………. m|__|

BMI: Underweight, normal, overweight, obese,

502

waist circumference …………………….cm

abdominal obesity YES/NO

503

Average clinic Systolic Blood pressure……………..mmHg

504

Average clinic Diastolic Blood pressure…………………mmHg

505

Heart rate………………………………..beats/min

506

Pulse pressure

PWA

601

PWV

602

Have arterial stiffness? YES/NO

603

Aix

604

Aix: Normal, increased

605

Central pulse pressure

606

Central blood pressure

SECTION 4: PARA-CLINICAL INVESTIGATIONS

701

CRP:

Range normal/high

702

Fasting Capillary glycemia:

Range hypo, normal, glucose intolerance, hyperglycemia