Don't let the name fool you. Despite their short-term duration, transient ischemic attacks (TIAs; "mini strokes") may not be "transient" after all. According to a new study, TIAs may have long-term consequences—they can shorten life expectancy by up to 20 percent.

The study, published online in the journal Stroke, analyzed the hospital and death records of more than 22,000 adults up to nine years after hospitalization for a TIA and found that the life expectancy of these patients was lower than that of the general population.

In addition, the study found that among patients who had experienced a TIA, mortality was greater in older people. Compared with people diagnosed with TIA under age 50, those ages 65 to 74 had a relative risk of early death that was almost five times higher, those ages 75 to 84 had a relative risk almost eight times higher and those 85 and older had a relative risk that was 11 times higher.

Several factors may explain this finding. However, the take-home point is that individuals already treated for TIA have more to gain from controlling their risk factors than those who have not yet experienced a TIA.

What is a TIA?

Sometimes referred to as "mini" strokes, TIAs originate in the same manner as a stroke but don't cause permanent brain damage. Both stroke and TIA occur when a clot blocks blood flow to the brain.

Sometimes the blocked artery reopens in time to avoid permanent damage. This is a TIA, and it explains why symptoms of brain dysfunction are of such short duration, disappearing within 24 hours or much sooner.

If the artery doesn't reopen or reopens too late, brain tissue is permanently damaged and can lead to long-term disability and even death. This is a stroke.

Symptoms of TIA

Symptoms of TIA include:

  • Numbness or weakness of the face, arms or legs, especially on one side of the body
  • Confusion, trouble speaking or difficulty understanding speech
  • Abrupt loss of vision in one or both eyes
  • Trouble walking, dizziness or loss of balance or coordination
  • A sudden headache without known cause

TIA Risk factors

Although your risk of TIA increases with age, there are other risk factors you can control. These include:

  • High blood pressure
  • High cholesterol
  • Smoking
  • Diabetes
  • An abnormal heart rhythm (atrial fibrillation)

According to the study, atrial fibrillation, congestive heart failure and hospitalization for stroke play the biggest role in the risk of early death after TIA. Fortunately, you can work with your doctor to control these conditions.

Most people can reduce TIA and stroke risk with aspirin therapy. However, don't take aspirin to reduce risk without discussing it with your doctor.

TIAs may be called "mini" strokes, but their long-term effects aren't minimal. Just like strokes, they're a medical emergency—requiring prompt attention.

Doctor's Viewpoint

Victor C. Urrutia, M.D., FAHA, Director, The Johns Hopkins Hospital Stroke Center

This study reaffirms the impact of transient ischemic attacks (TIAs) by showing that a TIA reduces the patient's survival over time. Take-home messages include:

  • TIAs should be treated seriously and require the same evaluation as stroke.
  • Older patients with TIA are at higher risk of early death and could benefit more from secondary preventive measures.

Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Publication Review By: the Editorial Staff at

Published: 14 Jul 2013

Last Modified: 06 Oct 2015