Blood clotting disorders: a big issue in adults
As women age, their hearts often deteriorate leading to atrial fibrillation or an irregular heartbeat.
A weak pulse and rapid heartbeat can lead to irregular coagulation, forming blood clots with the potential to travel to the brain or lungs, leading to loss of muscle movement, paralysis and death.
According to World Health Organisation, each year about 15 million people worldwide suffer from stroke. Approximately, 5 million of them die, and another 5 million remain disabled for life.
Col Preecha Uerojanaungkul, MD, head of the Division of Cardiovascular Medicine, Department of Medicine, Phramongkutklao Hospital, says that a stroke can be prevented in those who have a tendency to develop blood clots through the use of anticoagulant medications, namely warfarin, though it should be noted that dosage varies from person to person and such drugs must be used with caution.
Reactions to warfarin are affected by many factors including food containing high levels of vitamin K (green vegetables), exercise, alcohol consumption and medication non-compliance. It is thus vital that before prescribing the drug the physician is fully conversant with each patient’s daily routine and food consumption. For instance, do they normally eat a lot of vegetables? Are they taking dietary supplements and if so, which ones? Are they receiving other medications and which ones? This is important because some medicines and supplements can disturb the effectiveness of warfarin.
Even more essential is the careful monitoring of each patient. This is achieved by measuring International Normalised Ratio (INR) regularly, and at least every 4 weeks. If patients are very active and often change their diets – for example, adopting a vegetarian regime from time to time or running marathons – they may have to measure their INR level more often.
“Patients manage to maintain their INR at the targeted levels, because they regularly monitor their INR. Routine INR testing helps physicians adjust a patient’s warfarin dosage. This also helps reduce the risk of complications. If the INR is too low, there is a risk of stroke. If the INR is too high, there is a higher risk of haemorrhage,” Col Preecha says.
Patients can measure their INR themselves with a special testing device and consult their doctor should they see any variation to the normal target range.