GPs ‘failing to treat’ heart condition that increases stroke risk

Doctors across the UK are failing to treat people for a condition that significantly increases their risk of stroke, according to a new study.

Women in particular are less likely than men to receive the right treatment for abnormal heart rhythm, also known as atrial fibrillation (AF), as are the elderly.

NHS figures state there are 16,000 strokes every year in patients with AF, of which about 12,500 are thought to be directly attributable to AF.

The annual risk of stroke is five to six times greater in AF patients than in people with normal heart rhythm.

The research, published in the British Medical Journal (BMJ), involved analysis of GP records across the UK from 1999 to 2008. This included 32,151 patients who suffered a first stroke during this period.

According to Chest Heart & Stroke Scotland, there are about 13,000 strokes in Scotland each year. Of these, 3,000 are in someone under 65. Stroke is the greatest cause of severe disability in Scotland and the third most common cause of death.

Maddy Halliday, director Scotland of the Stroke Association, said it was important to recognise the risks posed by AF.

“Atrial fibrillation is a major risk factor for stroke. It accounts for 14 per cent of all strokes and over a thousand strokes a year are thought to be directly linked to the condition. The majority of people recognise factors such as smoking and high blood pressure as risk factors for stroke, yet, as this research highlights, public awareness of AF as a risk factor is incredibly low. Many people may not recognise the symptoms of AF as a serious health problem, resulting in them not being diagnosed and leaving them at risk of stroke.”

According to research carried out for the Stroke Association by MORI, 36 per cent of GPs in Scotland said they believed a lack of public awareness of the condition was a significant contributor to the problems that surround its diagnosis and treatment.

The authors of the BMJ report found that, over the study period, there was a consistent rise in prescriptions for preventive drugs, particularly those used to lower cholesterol and high blood pressure.

But doctors still routinely undertreated patients with AF.

Overall, 11 per cent of patients had been diagnosed with AF before their first stroke, and were therefore at significantly higher risk of death.

But only one in four of all those with AF were prescribed preventive anticoagulant (blood thinning) treatment, with no sign that prescribing increased as people’s risk went up.

Women were significantly more likely to have serious AF than men, but were less likely to be given anticoagulant therapy.

A Scottish Government spokesperson said: “We recognise the importance of ensuring that people with atrial fibrillation get detected and appropriately treated as soon as possible in order to minimise the risk of serious complications such as stroke. This will be something that our National Advisory Committee on Heart Disease will be considering later this year.”