Transient Ischemic Attack (TIA, Mini-Stroke) (cont.)
What is the treatment for a transient ischemic
attack (TIA)?
TIA Therapy
Treatment for a transient ischemic attack is aimed at preventing a second
stroke. Since there is no way of determining the severity of future episodes and
no guarantee that the symptoms will resolve, prevention of a future TIA or CVA
is crucial.
Treatment guidelines address a variety of targeted goals.
Anti-platelet therapy
- If the patient was not taking aspirin when the TIA occurred, it needs to
be started (325mg per day).
- If the patient was taking aspirin, then another anti-platelet drug
called dipyridamole needs to be added. Aggrenox is a combination of
aspirin
and dipyridamole.
- If the patient cannot tolerate aspirin, then clopidogrel (Plavix) should
be used.
High blood pressure therapy
- Even if the patient does not have hypertension or
high blood pressure, there
may be benefit in taking anti-hypertensive medications.
- Two classes of drugs are recommended to be started at the same time, a
diuretic and an ACE inhibitor.
- The goal for normal blood pressure is 120/80.
Cholesterol lowering therapy
Risk modification
Smoking, excessive alcohol, obesity and lack of physical activity are
considered risks for future stroke. The following recommendations are now
suggested:
- Smoking: Counseling,
smoking cessation aids like nicotine gum or
medications like varenicline (Chantix) should be considered. Environmental
smoke should be avoided.
- Alcohol: Intake should be limited to two or fewer drinks a day
for men and one or less for women.
- Obesity: Overweight people should try to lose weight using a
combination of diet, exercise and counseling. The goal is a BMI of 18.5-24.9
and a waist line of 35 inches or less for women and 40 inches or less for
men.
- Exercise: 30minutes of
moderate exercise daily is recommended for
those who are able. For patients with disabilities, a tailored exercise
program to their capabilities should be arranged.
Next: What is the prognosis for transient ischemic attack (TIA)? »
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