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    Minor Strokes May Lead to Major Ones

    Study: Stroke or Heart Attack Often Follow Within 10 Years

    TIA Study continued...

    TIAs can precede bigger strokes and other problems, as Agra and colleagues found.

    On average, Agra's participants were 65 years old. They signed up for the study within three months of their TIA or minor stroke. It's not known if that was their first such event.

    "Our study shows that, roughly 10 years after a presentation of TIA or minor ischemic stroke, about 60% of patients had died and 54% had experienced at least one new vascular event," says the study. "Event-free survival after 10 years was 48%."

    Risk's Patterns

    The risk of stroke is highest immediately following the first event. However, in the study it declined during the first three years and then gradually rose again.

    Death risk was higher for older participants, as well as those with diabetes, a history of a heart attack, and past surgery for poor circulation.

    'Like a Volcano'

    The risk may stem in part from increasing age, as well as plaque buildup in blood vessels, says Graeme Hankey, MD, FRCP, FRACP, of the stroke unit and neurology department at the University of Western Australia.

    Atherosclerosis (the hardening of the arteries) is a risk factor for heart disease and stroke. It behaves "like a volcano," writes Hankey. That is, it can seem to lie dormant for a long time before it blows its top by causing sporadic problems that can have deadly consequences.

    In a real volcano, lava is unavoidable. But in the body, you can curb plaque buildup through diet, exercise, and for some people, medication.

    Prevention Strategies

    There is room for improvement in long-term prevention strategies in TIA survivors, say Agra and colleagues.

    They don't give many details about prevention methods used by participants, except that all patients initially took aspirin. The study didn't assign patients to any particular plan.

    After a stroke or TIA, patients are often given blood-thinning or anticlotting drugs to help avoid future strokes. Lowering blood pressure and cholesterol, eating healthfully, being active, and following doctors' orders can also reduce stroke and heart attack risk.

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