UK doctors still undertreating atrial fibrillation - major risk factor for stroke
Despite significant improvements in stroke prevention over the past decade, and a fall in incidence and deaths, UK doctors are still undertreating one of the major risk factors - atrial fibrillation - reveals research published in BMJ Open.
Atrial fibrillation, or AF for short, describes abnormal heart rhythms. Its treatment has been prioritised in the NHS in a bid to cut preventable deaths and disability from stroke.
The researchers base their findings on an analysis of stroke data drawn from the General Practice Research Database (GPRD) for the period 1999 to 2008. The GPRD contains long term anonymised data on three million UK primary care patients.
More than 32,000 adults had a stroke, one in seven (15%) of which were fatal, during the study period.
Women were more likely to die of a stroke than men, even after taking account of age. The average age for a first stroke was 77 years for women and 71 years for men.
The figures showed significant improvements both in the number of new cases of stroke and in subsequent survival.
The prevalence of stroke rose by 12.5%, but the number of new cases fell by almost a third (30%) over the decade - from 1.48 per 1,000 person years in 1999 to 1.04 in 2008.
Among those aged 80 and over, who are at the highest risk of stroke, the fall was even greater, at 42%.
The rate of deaths within 56 days of a first stroke almost halved, falling from one in five (21%) in 1999 to nearly one in 10 (12%) in 2008.
These improvements were paralleled by a consistent rise in prescriptions for preventive drugs, particularly those used to lower cholesterol and high blood pressure, both of which are risk factors for stroke.
But doctors undertreated patients with atrial fibrillation, the findings showed.
Around one in 10 patients had been diagnosed with AF before their first stroke, and this group were at significantly higher risk of death from stroke than those who did not have AF.
But only one in four of all those with AF were prescribed preventive anticoagulant (blood thinning) treatment, with no sign that more serious AF was being targeted.
Women were significantly more likely to have serious AF than men, but they were less likely to be given anticoagulant therapy. This was prescribed for 29% of men with AF, but only 22% of women.
Both men and women with AF were more likely to be prescribed anticoagulants after a first stroke, but while this rose from 29% to 48% of men, it only rose from 22% to 35% of women.
The authors conclude that primary care doctors are tackling the risk factors for stroke much more effectively. "However, there is a clear suggestion that risk stratification is not yet optimal, particularly in relation to patients with AF," they write.
Provided by British Medical Journal
- Review of stroke treatment could save lives Sep 30, 2011 | not rated yet | 0
- Kidney disease increases the risk of stroke in patients Mar 04, 2009 | not rated yet | 0
- The Medical Minute: Atrial Fibrillation -- What is It? Oct 06, 2011 | not rated yet | 0
- The big risk factor for stroke that you may not know you have Sep 15, 2011 | not rated yet | 0
- Atrial fibrillation: New management approaches for the 'new epidemic' in cardiovascular disease Jun 26, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
No new human cases of the H7N9 virus have been recorded in China for a week, national health authorities said, for the first time since the outbreak began in March.
Diseases, Conditions, Syndromes 33 minutes ago | not rated yet | 0
A Nobel prize-winning scientist Tuesday played down "shock-horror scenarios" that a new virus strain will emerge with the potential to kill millions of people.
Diseases, Conditions, Syndromes 51 minutes ago | 5 / 5 (1) | 0
Bacteria resistant to the antibiotic colistin are also commonly resistant to antimicrobial substances made by the human body, according to a study in mBio, the online open-access journal of the American Society for Microb ...
Diseases, Conditions, Syndromes 5 hours ago | 5 / 5 (1) | 0
(AP)—Federal investigators probing the hantavirus outbreak blamed for three deaths at Yosemite National Park recommend that design changes to tent cabins and other lodging run by private concessionaires first be reviewed ...
Diseases, Conditions, Syndromes 11 hours ago | not rated yet | 0
A new diagnostic test for a worm infection that can lead to severe enlargement and deformities of the legs and genitals is far more sensitive than the currently used test, according to results of a field ...
Diseases, Conditions, Syndromes 12 hours ago | not rated yet | 0 |
(Medical Xpress)—A three-year multinational study has tracked and detailed the progression of Huntington's disease (HD), predicting clinical decline in people carrying the HD gene more than 10 years before ...
44 seconds ago | not rated yet | 0
Johns Hopkins researchers say they have discovered specific chemical alterations in two genes that, when present during pregnancy, reliably predict whether a woman will develop postpartum depression.
1 hour ago | not rated yet | 0 |
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
11 hours ago | 4.6 / 5 (13) | 5 |
New research suggests that a compound abundant in the Mediterranean diet takes away cancer cells' "superpower" to escape death. By altering a very specific step in gene regulation, this compound essentially re-educates cancer ...
14 hours ago | 4.8 / 5 (12) | 2 |
Children who have suffered maltreatment are 36% more likely to be obese in adulthood compared to non-maltreated children, according to a new study by King's College London. The authors estimate that the prevention or effective ...
1 hour ago | not rated yet | 0
Salamanders' immune systems are key to their remarkable ability to regrow limbs, and could also underpin their ability to regenerate spinal cords, brain tissue and even parts of their hearts, scientists have ...
14 hours ago | 4.8 / 5 (6) | 2 |