Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Atrial fibrillation is a 'modifiable' risk factor for stroke

29.10.2012
New anti-thrombotic treatments in atrial fibrillation patients can reduce the stroke risk

Atrial fibrillation, whose prevalence continues to rise, was described last year as the "new epidemic" in cardiovascular disease, even though AF can be successfully controlled by the detection and management of risk factors, by rhythm control treatments, and by the use of antithrombotic therapies.(1)

These therapies have been improved in the past few years by the introduction of new anticoagulant drugs, such that AF - like high blood pressure or smoking - may now be considered a "modifiable" risk factor for stroke, whose treatment can reduce the degree of risk.

Professor Freek Verheugt, from the Onze Lieve Vrouwe Gasthuis in Amsterdam and speaking on behalf of the European Society of Cardiology (ESC), says: "All individuals with irregular heart beat should see a doctor, who can diagnose whether this heart rhythm disorder is likely to lead to stroke. If so, blood thinning medication can reduce the risk of stroke by up to 70%."

The latest ESC Clinical Practice Guidelines on Cardiovascular Disease Prevention, which were revised this year, describe stroke as the "second major cardiovascular disease" (after coronary heart disease) and, like CHD, with enormous scope for prevention.(2) Indeed, more than 50% of the reductions seen in heart disease mortality over recent decades relate to changes in risk factors. In addition, the treatments prescribed to lower blood pressure, for example, also reduce the risk of stroke, such that stroke prevention is still the most evident effect of antihypertensive treatment.

The overall theme of this year's World Stroke Day http://www.worldstrokecampaign.org/2012/Pages/Home.aspx on 29th October is "One in Six", referring to the facts that one in six people will have a stroke at some point in their lifetime, and that a stroke will be the cause of someone's death every six seconds. These, says the World Stroke Organization, are everyday people leading everyday lives, but around 85% of them will have risk factors which, if identified, are preventable.

The Interstroke study, which was reported in 2010 following an analysis of stroke data from 22 countries, indicates that just ten risk factors are associated with 90% of total stroke risk.(3) The highest attributable effect of individual risk factors was 35% from hypertension, 26.5% for waist-to-hip ratio, and 19% for current smoking.(3)

The ESC emphasises that most of these risks for stroke are also the same major risks for coronary heart disease - high blood pressure, smoking, obesity, lack of exercise and excessive alcohol consumption. In addition, AF, this common disorder of heart rhythm, is also clearly associated with an increased risk of stroke. Indeed, the very latest ESC guidelines on AF, published in August, state: "Diagnosing AF before the first complications occur is a recognized priority for the prevention of strokes", and that "even short episodes of 'silent' AF convey an increased risk for stroke".(4)

While the guidelines advise that the evidence in favour of aspirin in stroke prevention is "weak", they add that a new range of anticoagulant drugs are "broadly preferable" for stroke prevention in AF, but, because experience remains limited, they are recommended within the context of "strict adherence to approved indications". The guidelines state that these novel anticoagulants "offer efficacy, safety, and convenience" compared with previous therapies.

Professor Verheugt emphasises that stroke is not an inevitable consequence of ageing and that, by identifying and modifying risk factors, there are substantial opportunities to reduce stroke risk - through lifestyle interventions and the control of high blood pressure and AF.

According to the World Stroke Organization, there are six steps that anyone can take to reduce their risk of stroke:
Know your personal risk factors: high blood pressure, diabetes, and high blood cholesterol
Be physically active and exercise regularly
Avoid obesity by keeping to a healthy diet
Limit your alcohol consumption
Avoid cigarette smoke. If you smoke, seek help to stop
Learn to recognise the warning signs of a stroke
And the latest ESC guidelines on cardiovascular disease prevention also emphasise the wisdom of a healthy diet, appropriate body weight, physical activity and no smoking.

Editors' notes

1. Atrial fibrillation is now prevalent in almost 2% of the general population, with the average age of patients steadily rising - presently between 75 and 85 years. AF is associated with a five-fold risk of stroke and three-fold risk of heart failure.

2. European Clinical Practice Guidelines on cardiovascular disease prevention in clinical practice (version 2012), Eur Heart J 2012; 33: 1635-1701.

3. O'Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376: 112-123.

4. The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC). 2012 focused update of the ESC Guidelines for the Management of Atrial Fibrillation. Eur Heart J 2012; doi:10.1093/eurheartj/.

* Stroke (which is also known as cerebrovascular disease) occurs when a blood vessel carrying oxygen to the brain is either blocked by a clot (ischaemic stroke) or bursts (haemorrhagic stroke). Without oxygen and nutrients, brain cells begin to die, and it is the extent and location of this damage which determines the severity of the stroke. The World Health Organization has defined stroke as "a neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours".

* More information on this press release is available from the ESC's press office
press@escardio.org
+33 (0)4 92 94 8627

ESC PRESS OFFICE | EurekAlert!
Further information:
http://www.escardio.org

More articles from Health and Medicine:

nachricht Cystic fibrosis alters the structure of mucus in airways
29.06.2017 | University of Iowa Health Care

nachricht Mice provide insight into genetics of autism spectrum disorders
28.06.2017 | University of California - Davis

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making Waves

Computer scientists use wave packet theory to develop realistic, detailed water wave simulations in real time. Their results will be presented at this year’s SIGGRAPH conference.

Think about the last time you were at a lake, river, or the ocean. Remember the ripples of the water, the waves crashing against the rocks, the wake following...

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Nanostructures taste the rainbow

29.06.2017 | Physics and Astronomy

New technique unveils 'matrix' inside tissues and tumors

29.06.2017 | Life Sciences

Cystic fibrosis alters the structure of mucus in airways

29.06.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>