Understanding Ways to Avoid TIAs
TIA Prevention Through Making Good Health DecisionsOnce you know your TIA risk factors, the next step in TIA prevention is doing something about the TIA risk factors that you have. So what are good choices for preventing a TIA? They include:
- Controlling blood pressure and cholesterol
- Preventing or managing diabetes
- Controlling atrial fibrillation or other heart conditions
- Quitting (or not starting) smoking
- Engaging in regular exercise
- Maintaining a healthy weight
- Eating a well-balanced, heart-healthy diet
- Drinking alcohol in moderation (if you drink)
- Not using illegal drugs.
Controlling Blood Pressure
High blood pressure (also known as hypertension) is by far the most potent risk factor for a TIA and stroke. High blood pressure is defined as an average blood pressure higher than 140/90 mmHg with multiple blood pressure readings. "Prehypertension" is any level higher than 120/80 mmHg.
People with hypertension often have no high blood pressure symptoms, so have your blood pressure checked every one to two years. If you have high blood pressure, your doctor may suggest you make some lifestyle changes, such as eating less salt (see DASH Diet) and exercising more. Your doctor may also prescribe blood pressure medicine.
(Click Lowering Blood Pressure for more information.)
Cholesterol is a fat-like substance in the blood. High cholesterol does not cause damage over days, weeks, or months. Rather, over years, high blood cholesterol can lead to atherosclerosis, which is a narrowing or complete blockage of arteries because of the buildup of plaque. Both arteries in the brain and neck are affected by plaque buildup.
Research studies have shown that the progress of atherosclerosis may be stopped by reducing cholesterol levels. In some cases, it may even be reversed. This results in fewer people having TIAs and strokes.
You should have your blood cholesterol and triglyceride levels checked (with a lipid panel test) at least once every five years. If your triglyceride or cholesterol levels are high, talk to your doctor about what you can do to lower them. You may be able to lower your cholesterol and triglyceride levels by eating better (see Low Cholesterol Diet) and exercising more (see Exercise and Cholesterol). Your doctor may also prescribe cholesterol medication.
(Click Lowering Cholesterol for more information on treating high cholesterol.)
Preventing or Managing Diabetes
About 17 million people in the United States have diabetes, and TIAs and strokes are common in people with the condition. Diabetes is a disease in which the body does not properly produce or use insulin. Insulin is a hormone needed to convert sugar, starches, and other nutrients into energy.
Another 16 million Americans have pre-diabetes, a condition in which blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetes.
One in three people who have diabetes don't know they have it. See a doctor if you have any diabetes symptoms, which include:
- Frequent urination
- Excessive thirst
- Extreme hunger
- Unusual weight loss
- Increased fatigue
- Blurry vision.
If you have diabetes, your doctor will decide if you need diabetes medicine, such as pills or insulin shots. Your doctor can also help you design a healthy eating and exercise plan.
(Click Diabetes Treatment for more information.)
Controlling Atrial Fibrillation
People who have atrial fibrillation are more likely to have a TIA or stroke than people who have a normal heart rhythm.
Treatment for atrial fibrillation depends on the severity of the atrial fibrillation. In a lot of cases, treatment involves medicines called anticoagulants (or "blood-thinners") such as warfarin (Coumadin®, Jantoven®). Warfarin can prevent clots from forming. Aspirin also is used to reduce the risk of TIA in people with atrial fibrillation; however, the most recent clinical studies have shown that warfarin is superior to aspirin in preventing TIAs and strokes.
Controlling Other Heart Problems
Common heart disorders can result in blood clots that may break loose and block vessels in or leading to the brain. Heart disorders can include:
- Coronary artery disease (CAD), which most people simply refer to as heart disease
- Heart valve defects, such as mitral valve stenosis
- Irregular heart rhythms other than atrial fibrillation
- Congestive heart failure
- Recent history of a heart attack.
Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots.
Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, which is the main neck artery that supplies blood to the brain. Nicotine raises blood pressure; carbon monoxide reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Because of these combined effects, smoking increases a person's chances of having a TIA or stroke.
Your doctor can recommend programs and medications that may help you quit smoking.
Exercise improves heart function, lowers blood pressure and "bad cholesterol" (LDL), raises "good cholesterol" (HDL), and boosts energy. Many people think this means having to do a lot of strenuous exercise every day. This is a myth. A moderate exercise program will help keep your heart and blood vessels in shape and help to lower blood pressure.
The American Heart Association even classifies walking at a brisk pace for 30 to 60 minutes, three days a week, as "regular physical activity." Also, you don't have to fit all your physical activity into one exercise session. You can break it up into 10-minute sessions or whatever works best for you. Your healthcare provider can help you with come up with a good exercise plan to help in TIA prevention.
Maintaining a Healthy Weight
If you are overweight, losing weight can help you in several ways. Carrying extra weight puts additional strain on your heart. Also, as people gain weight, their blood pressure and cholesterol levels tend to rise. Losing weight can help lower high blood pressure and high cholesterol.
Your healthcare providers can help you fashion a diet and exercise program that's right for you and your weight-loss goals. To lose weight, doctors usually recommend a low-fat, low-cholesterol, and low-salt diet, along with an exercise program.
Following a Heart-Healthy Diet
In order to reduce the chances for a TIA or stroke, you should follow a heart-healthy diet. This means a following a diet that's low in fat, cholesterol, and salt, and high in fruits, vegetables, whole grains, and fiber. It doesn't mean that you can never have pizza or ice cream again. Experts point out that eating heart-healthy foods should be the routine. That way, when you have high-fat food every now and then, you're still on track. Making a high-fat diet the routine is asking for trouble.
A heart-healthy diet includes the following:
- 8 to 10 percent of the day's total calories from saturated fat.
- 30 percent or less of the day's total calories from fat.
- Less than 300 milligrams of dietary cholesterol a day.
- A sodium intake of 2,400 milligrams a day.
- Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level. (Ask your doctor or registered dietitian what is a reasonable calorie level for you.)
Medications and Procedures Used in TIA PreventionAs part of a TIA prevention plan, you may need medications in addition to making lifestyle changes. Some medications decrease the ability for your blood to clot or prevent clots from getting bigger if they do form. Medicines used for TIA prevention include:
- Warfarin (Coumadin®, Jantoven®)
- Clopidogrel (Plavix®)
- Ticlopidine (Ticlid®)
- Dipyridamole (Persantine®)
- Aspirin and dipyridamole (Aggrenox®).
Doctors may also recommend certain procedures to treat conditions known to increase the risk for a TIA. One of these procedures is a carotid endarterectomy.
A carotid endarterectomy is a surgical procedure in which a doctor removes fatty deposits blocking one of the two carotid arteries, the main supply of blood for the brain. Carotid artery problems become more common as people age. The disease process that causes the buildup of fat and other material inside the artery walls is called atherosclerosis, popularly known as "hardening of the arteries." The fatty deposit is called plaque; the narrowing of the artery is called stenosis. The degree of stenosis is usually expressed as a percentage of the normal diameter of the opening.
The surgery can be highly beneficial for people who have already had a TIA or who have a severe narrowing of the carotid artery.
Final Thoughts on TIA PreventionTIA prevention is important because one-third of people who have a TIA will go on to have a stroke within five years. This risk is significantly decreased with good prevention strategies and treatment.
Regardless of your age, background, or health status, you can lower your risk for a TIA -- and it doesn't have to be complicated. Protecting your brain can be as simple as taking a brisk walk, whipping up a good vegetable soup, or getting the support you need to maintain a healthy weight.
And the good news: Research shows that people can lower their risk for a TIA significantly simply by adopting sensible health habits.
As with anything in life, there are no guarantees. You could do all the right things and have a TIA or stroke, because there are so many factors involved. Whether you are already healthy, are at high risk for a TIA, or have already had a TIA, the advice to protect your brain is the same.