‘UK-wide screening needed urgently to slash stroke deaths’

National screening programmes for over-65s should be “urgently” introduced to reduce the number of premature deaths caused by stroke, according to medical experts.

The call to both the Scottish and UK governments comes following a meeting of more than 120 stroke specialists convened by the Royal College of Physicians of Edinburgh (RCPE), which was held to find methods of improving diagnosis and treatment for atrial fibrillation (AF), a heart condition which significantly increases the risk of stroke.

This is the most common, sustained, heart disorder and the risk factors increase with age.

Experts said blood-thinning drugs can be used to treat the condition but it is often under-treated as it does not always display symptoms.

The two-day meeting held last week allowed delegates to review the current evidence and produce clinical guidance for the NHS.

Recommendations include the need for a national screening programme. Experts said the most cost-effective way of doing so would be to target all over-65s by checking pulses in GP surgeries.

Dr Scott Ramsay, consultant in stroke medicine, said: “Atrial fibrillation is often a silent condition with serious consequences in the form of stroke.

“Its symptoms can go undetected, there has been uncertainty amongst doctors regarding how to treat it effectively and a lack of medical and public awareness about sufferers’ significantly increased risk of developing a stroke.

“The goal of treating atrial fibrillation is primarily to reduce the current unacceptable levels of avoidable stroke and the disability and premature death it causes.

“This is an issue of national significance and we have reached consensus that the most effective way of doing this would be for national screening programmes to be introduced throughout the UK for all people over 65 as a matter of urgency.”

Another of their key recommendations was to increase the use of anti-coagulant treatments (blood-thinning drugs).

They also warned that aspirin has proven to be “ineffective” in preventing stroke in AF and should not be used.

The RCPE UK Consensus Statement on Atrial Fibrillation said patients currently being prescribed aspirin for the condition should be reviewed and offered anticoagulation or have aspirin withdrawn.

Dr Ramsay added: “It is clear that the evidence has moved on and historic methods of stroke prevention in atrial fibrillation, such as prescribing aspirin instead of anticoagulants have proven to be ineffective but have significant side effects.

“For all patients in atrial fibrillation, except those few at truly low risk of stroke, anticoagulation is the only effective stroke prevention.”

A Scottish Government spokesman said: “Tackling heart disease and stroke continues to be a clinical priority for NHS Scotland.

“Figures published in November show NHS Scotland surpassed its target achieving a 50 per cent reduction in premature stroke deaths.”

AF arises from an irregular heartbeat and symptoms include palpitations, chest pain, breathlessness and dizziness.