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Transient Ischemic Attack


Prevention & Expectations

What can be done to prevent the condition?

Transient ischemic attacks can be minimized by addressing known risk factors for stroke. The American Heart Association guidelines for stroke prevention address both modifiable and less well-documented or potentially modifiable risk factors.

Measures to reduce the modifiable risk of high blood pressure include:

  • measurement of blood pressure in adults at least every 2 years to screen for high blood pressure
  • weight control
  • physical activity
  • moderation in alcohol intake
  • moderate sodium intake
  • for those who smoke, quitting smoking
  • medications to treat high blood pressure if the person's blood pressure is over 140/90 after 3 months of these lifestyle modifications, or if the initial blood pressure is over 180/100
  • Other measures to reduce an individual's modifiable risk factors for stroke may include:

  • smoking cessation using nicotine patches, counseling, and formal smoking programs
  • control of blood sugar levels in a person with diabetes through medication, diet, and exercise
  • the use of ramipril in people with diabetes. A recent study showed that people with diabetes have a 33% lower risk of stroke if they take ramipril.
  • careful evaluation of asymptomatic carotid stenosis to determine the need for surgery. Coronary artery surgery, such as an endarterectomy, may be indicated. An endarterectomy opens the narrow portion of the artery and increases the blood flow to the brain. People with carotid stenosis should also work closely with their healthcare providers to control other risk factors for stroke.
  • semiannual screening of children with sickle cell anemia, using ultrasound to determine the child's risk of stroke
  • treatment of atrial fibrillation with blood thinners such as aspirin or warfarin, depending on the person's age and other risk factors
  • monitoring of high levels of total cholesterol or LDL, as well as low levels of HDL. Depending on the blood levels and the person's other risk factors, medications to lower cholesterol may be given.
  • Measures to reduce less well-documented or potentially modifiable risks for stroke may include:

  • weight reduction in overweight persons
  • 30 or more minutes of moderate exercise a day for most individuals. People with heart disease or disabilities should be in a medically supervised exercise program.
  • a healthy diet for preventing heart disease, containing at least 5 fruits and vegetables a day
  • for those who drink alcohol, drinking in moderation. The AHA defines moderate drinking as no more than 2 drinks a day for men and 1 drink a day for women.
  • seeking treatment for drug abuse
  • monitoring of blood levels of homocysteine. For most individuals, a well-balanced diet following the food guide pyramid will provide enough folic acid and B vitamins to maintain a healthy homocysteine level. For people with elevated homocysteine levels, supplements containing folic acid and B vitamins may be recommended.
  • avoiding the use of oral contraceptives in women with other stroke risk factors
  • What are the long-term effects of the condition?

    There are usually no long-term effects of the transient ischemic attack itself. However, a recent study showed that people who had a TIA increased their chance of having a stroke by 50% in the 3 months following the TIA. Twenty percent of these strokes were fatal, and two-thirds were disabling.

    Furthermore, the increased risk of stroke in the 3 months after a TIA was linked to 5 factors:

  • age over 60 years
  • diabetes
  • a TIA lasting more than 10 minutes
  • weakness with the TIA
  • speech impairment with the TIA
  • What are the risks to others?

    TIAs are not contagious and pose no risks to others.


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