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 Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center

nachricht Study advances gene therapy for glaucoma
17.01.2018 | University of Wisconsin-Madison

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: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

Im Focus: A thermometer for the oceans

Measurement of noble gases in Antarctic ice cores

The oceans are the largest global heat reservoir. As a result of man-made global warming, the temperature in the global climate system increases; around 90% of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Gran Chaco: Biodiversity at High Risk

17.01.2018 | Ecology, The Environment and Conservation

Only an atom thick: Physicists succeed in measuring mechanical properties of 2D monolayer materials

17.01.2018 | Physics and Astronomy

Fraunhofer HHI receives AIS Technology Innovation Award 2018 for 3D Human Body Reconstruction

17.01.2018 | Awards Funding

VideoLinks
B2B-VideoLinks
More VideoLinks >>>