Published in the Lynn Haven Ledger, May 2011
TIA Prevention Article by: Jennifer Clark, PA-C, MPAS
5
0,000 Americans suffer from TIAs (Transient Ischemic Attack) every year; and of those 50,000 people, approximately one third will unfortunately progress to have a stroke, also known as a Cerebral Vascular Accident (CVA). Most of us are aware of the detrimental effects of a stroke, but we are not as familiar with the signs and symptoms of a TIA or what we can do to prevent one from occurring. By understanding what exactly a TIA is, as well as the risk factors for developing one, we can enable ourselves to take proactive measures in preventing it from happening all together! A transient ischemic attack is defined as a sudden focal loss of neurological function that completely resolves within 24 hours. This is caused by a brief period of inadequate blood flow from either the carotid or vertebral arteries to the brain. The symptoms of a TIA happen suddenly and can include vision loss often described as a curtain closing over the eye, difficulty with speech, weakness or inability to move one side of the body, or facial drooping. . A stroke (CVA) differs from a TIA in that it is a neurological deficit that is often permanent and occurs as a result of tissue death due to lack of blood flow to a region of the brain due to either a hemorrhage or a blockage of an artery. Certain risk factors predispose us to developing TIAs. Uncontrolled hypertension or high blood pressure is certainly the most important. This can be a silent risk factor since hypertension is often asymptomatic. It is important to check your blood pressure regularly, whether with your family physician or when you are at the store or the gym and a blood pressure monitor is available. Any blood pressure reading greater than 140/90 is considered high blood pressure and needs to be evaluated and treated. If you have a diagnosis of hypertension, make sure you are taking your medications as directed and are following up frequently with your doctor to ensure it is controlled appropriately. High blood pressure can also be affected by our diet; therefore it may be recommended that you start a low sodium diet. Elevated cholesterol, also known as hyperlipidemia, can lead to atherosclerosis, or development of plaque in the arteries. We should be screened for hyperlipidemia every five years, and if diagnosed should be on medications to help lower cholesterol, which in turn will help stop the progression of atherosclerosis. If diagnosed with hyperlipidemia, it is imperative to follow up frequently to monitor effects of treatment with medication and lifestyle modification. Carotid artery disease is also linked to TIAs. This is often discovered by physical exam, if your practioner hears any abnormal sound in the neck then an ultrasound can be obtained for further evaluation. A screening ultrasound may also be ordered based on age and risk factors. Taking a daily baby aspirin and maintaining control of cholesterol helps prevent progression of carotid artery disease. Cigarette smoking not only increases the risk for TIAs, but it increases the risk for having a stroke by 2.5 times!
Article continued on the back
By stopping smoking not only do you decrease chances for stroke and TIAs, but you help reduce risk of disease throughout the entire body. Smoking is linked to numerous types of cancer and disease, therefore quitting is one of the most important things you can do for your health. Atrial fibrillation is another risk factor for TIAs. This is a diagnosis of an irregular heartbeat. If you check your pulse and notice that it is irregular, make sure you make an appointment for further evaluation. Diabetes Mellitus that is uncontrolled is also a condition that can predispose you to TIAs as well as heart disease. Maintaining an ideal body weight and following the American Diabetic Association recommendations for diet as well as frequent visits to your family medicine clinic or endocrinologist and ophthalmologist is essential for management of this disease. Obesity and sedentary lifestyle are both risk factors that we can reverse. Eating a sensible diet and cardiovascular exercise are very important lifestyle changes we all need to incorporate! The American Heart Association recommends 150 minutes of cardiovascular exercise a week, or five 30 minute sessions. If you are completely inactive this may seem like a lot, but if you gradually change your lifestyle to incorporate physical activity, this is a highly attainable goal. Limit the use of alcohol consumption to more than two drinks a day for men and one drink a day for women. Prevention consists of understanding risk factors and making necessary lifestyle changes helps decrease the chances of developing a transient ischemic attack in the future. While we can’t change our genetics, we do have the ability to change how we live our lives and our health, and making simple changes to the way we do things can help improve our quality of life for many years to come.