Estimating the Risk of Stroke and Bleeding
Medications that prevent blood clots from forming are used to reduce your risk of having a blood clot-related stroke. The type of medication used depends on your risk of having a stroke as well as your risk of bleeding.
People who have heart failure, high blood pressure or diabetes are at higher risk of having a stroke. Also, if you are 65 years or older or if you have already had a stroke or mini-strokes in the past, you are also at higher risk.
Your risk of bleeding also has to be considered because the medications can cause bleeding.
People with liver or kidney problems or high blood pressure may have a higher risk of bleeding. As well, some medications that you are already taking or regular alcohol consumption may also increase the risk of bleeding.
When deciding the best way to reduce your risk of stroke, your doctor will consider all these facts before recommending which strategy is best for you.
Signs of a Stroke
People with atrial fibrillation are up to five times more likely to have a stroke. It is important to know the signs:
- Weakness - Sudden loss of strength or sudden numbness in the face, arm, or leg (even if temporary)
- Trouble speaking - Sudden difficulty speaking or understanding, or sudden confusion (even if temporary)
- Vision problems - Sudden trouble with vision (even if temporary)
- Headache - Sudden severe and unusual headaches
- Dizziness - Sudden loss of balance, especially with any of the above signs.
To learn more about recognizing a stroke, see Signs of stroke from the Heart & Stroke Foundation.
If, at any time, you think you may be having a stroke, call 9-1-1.
Medications
Anticoagulant Medications (Most Commonly Recommended)
To prevent blood from clotting inside your heart, your doctor may prescribe you a medication called an anticoagulant—sometimes called a blood thinner.
Anticoagulants don’t actually thin your blood. Rather they increase the time that it takes to form a blood clot. The type of anticoagulant that your doctor recommends for you will depend on other medical conditions that you may have along with your overall risk of having a stroke.
Anticoagulants are very effective at reducing your risk of stroke and are recommended for almost all people who have atrial fibrillation.
Some anticoagulants require regular blood tests initially, until the best dose for you is determined.
Antiplatelet Medications (Less Commonly Used)
Other medications also prevent blood clots but work in a different way.
Platelets normally float around in your blood stream. Their job is to form blood clots in the case of a bleeding injury. Antiplatelet medications reduce the ability of platelets to stick together and form clots.
Antiplatelet medications are used less commonly because they are not as effective as anticoagulants in reducing your risk of having a stroke.
The following table lists some of the most common types of anticoagulant and antiplatelet medications. Once your doctor determines the best medication, you will be able to get more details and ask questions. Your pharmacist is also a good source of information about your medications.
| Type of Medication | Examples | |
|---|---|---|
| Anticoagulant |
Acenocoumarol (Sintrom®) Apixaban (Eliquis® Dabigatran (Pradaxa®) |
Edoxaban (Lixiana) Rivaroxaban (Xarelto® |
| Antiplatelet | ASA (Aspirin®) | Clopidogrel (Plavix® |
Cautions
When you are taking anticoagulant or antiplatelet medications, your risk of bleeding is higher. See the Heart Institute’s Anticoagulation Medication Patient Information booklet for more information.
Here are a few tips to prevent bleeding problems:
- Use a soft toothbrush.
- Avoid contact sports or activities in which injuries are common.
- If you have a minor cut or bruise, treat it as you normally would but, if the bleeding does not stop, seek medical help immediately.
Make sure your dentist knows that you are taking anticoagulant or antiplatelet medications before you have any dental work done.
Carry a list of all of your medications so that any doctor or other health care professional (for example, a nurse or physiotherapist) knows that you are taking this type of medication.
Seek immediate medical attention for the following:
- Large amounts of noticeable bleeding
- Red, dark, coffee-coloured or cola-coloured urine
- Bowel movements that are red or look like tar
- Bleeding from the gums or nose that does not stop quickly
- Vomit that is coffee-coloured or bright red
- Anything red in colour that you cough up
- A cut that will not stop bleeding within 10 minutes
- A serious fall or hit on the head
- Any unexplained dizziness or weakness