NATIONAL screening programmes for over-65s should be "urgently" introduced to reduce the number of premature deaths caused by stroke, according to medical experts.
It is predicted up to 500 strokes and 180 deaths in Scotland – and 5000 strokes and 2000 deaths UK-wide – could be prevented each year with improved diagnosis and treatment for atrial fibrillation, a common heart disorder which significantly increases the risk of stroke with age.
The call to the Scottish and UK governments came at a meeting of more than 120 stroke specialists from around the country. Convened by the Royal College of Physicians of Edinburgh (RCPE), it was held to find more efficient ways of better diagnosing and treating atrial fibrillation.
The two-day meeting involved reviewing the current evidence to produce clinical guidance for the NHS.
Experts said blood-thinning drugs can be used to treat the condition, but it is often undertreated as it does not always display symptoms.
Recommendations reached 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. Further tests would then be arranged for those with irregular pulses.
A stroke, also known as a cerebrovascular accident (CVA), is the rapid loss of brain function due to a disturbance in the blood supply to the brain. According to the Scottish Stroke Association the condition is the third biggest cause of death among Scots. An estimated 13,000 people have a first stroke in Scotland each year of which one-third will die, one-third will recover well, but the remainder will survive with one or more impairment – including physical, sensory, neurological and psychological. There are an estimated 110,000 stroke survivors living in Scotland.
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 among 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 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 key recommendation was to increase the use of anticoagulant treatments – blood-thinning drugs. They also warned that aspirin has proven to be "ineffective" in preventing stroke in atrial fibrillation.
The RCPE UK Consensus Statement on Atrial Fibrillation said patients prescribed aspirin should be reviewed and offered anticoagulation or have aspirin withdrawn.
Dr Ramsay added: "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 low risk of stroke, anti-coagulation is the only effective stroke prevention and should be offered as treatment."
Atrial fibrillation arises from an irregular heartbeat and presents symptoms of palpitations, chest pain, breathlessness and dizziness.
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