Heart Attack and Atherosclerosis Prevention (cont.)

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Transient ischemic attack (TIA)

A transient ischemic attack (TIA) often is referred to as a mini-stroke. TIAs are caused by the temporary reduction in flow of blood (ischemia) to the brain and is most often caused by a clot that spontaneously forms in a carotid artery. Patients with TIA's often have narrowed (or, less often, ulcerated) carotid arteries due to atherosclerosis. TIAs typically last 2 to 30 minutes, although symptoms sometimes can last 24 hours and can produce problems with vision, dizziness, weakness of the arms or legs, and trouble speaking. A TIA is different from a stroke in that it does not cause permanent death of brain tissue. Without treatment, however, patients with TIAs are at high risk for having a stroke with permanent damage to the brain.

When does the coronary atherosclerosis process begin?

Although the coronary arteries are wide open at birth, the atherosclerosis process begins early in life. Between the ages of 10 and 20, "fatty streaks" are already being deposited on the inner lining of the coronary arteries. Over the years, some of these fatty streaks grow into larger cholesterol plaques that can protrude into the artery lumen and harden the artery walls. Many men and women between the ages of 20 and 30 typically are unaware that their coronary arteries are gradually accumulating cholesterol plaques. By ages 40 to 50, many people have developed enough atherosclerosis to put them at risk for coronary heart disease.

Have most people done enough to prevent atherosclerosis and heart attacks?

Atherosclerosis prevention should start early, preferably during childhood and adolescence. Most scientists believe that preventing atherosclerosis is more effective than trying to reverse established blockages or getting rid of plaques in the arteries. Therefore, children and adolescents should be taught lifetime habits of regular exercise, avoidance of smoking, and good nutrition. Unfortunately, many Americans have not taken adequate steps to prevent atherosclerosis. Reasons for this failure include:

  • Lack of awareness that they already have coronary atherosclerosis, and ignorance that coronary atherosclerosis and heart attacks are preventable;
  • Lack of awareness of their blood cholesterol levels and profiles;
  • Unwillingness or inability to quit cigarette smoking;
  • High blood pressure or diabetes mellitus that are either undiagnosed or inadequately controlled;
  • Lack of exercise, an excess of fat and cholesterol in their diet, and an inability to lose excess weight; and
  • Failure to take full advantage of medications that improve cholesterol profiles, usually out of fear of potential side effects.
Medically Reviewed by a Doctor on 2/6/2014

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