Irrespective of whether the atrial fibrillation is constant or occurs in paroxysms, that is, it is intermittent, the decision to administer antiplatelet drugs or anticoagulants should depend on the patient’s cumulative risk factors. These risk factors include age and previous medical history.
Looking to the future for the management of AF and prevention of stroke
Atrial fibrillation (AF) is becoming an epidemic, affecting 1% to 2% of the population in the developed world. Looking to the future, the prevalence of AF will grow dramatically in the coming decades as the elderly population increases. The growing numbers underline the need to improve the detection of patients with AF and measures for reducing their risk of stroke.
It takes a minute: check your patient’s pulse to see if they are in atrial fibrillation
The prevalence of atrial fibrillation (AF) is increasing with the ageing population. It is well worth detecting and treating as it carries a significant risk of debilitating disease, including stroke and heart failure. This article explains some of the health risks and describes simple actions that can play an important part in both the prevention and management of AF and its consequences.
Why does atrial fibrillation increase the risk of stroke?
Each year there are 150,000 strokes in the UK. Nearly one in five (18%) of the people presenting with a stroke are in atrial fibrillation (AF) at the time of presentation, and one in six strokes are directly attributable to AF. The risk of stroke in AF is reduced by two-thirds with oral anticoagulation, while antiplatelet therapy reduces stroke by one-fifth. The reduction with antiplatelet therapy is broadly consistent with the stroke reduction seen with this therapy in patients with vascular disease or risk factors, and, given that AF largely coexists with vascular disease, the effect of antiplatelet therapy would probably reflect this. The risk of stroke is similar with paroxysmal or permanent AF, in the presence of associated risk factors.
Three simple steps to reduce strokes associated with atrial fibrillation
Stroke is devastating – for the person affected, their family and the NHS. Figures in the recent NICE guideline on stroke show that around 110,000 people have a first or recurrent stroke each year in England, and a further 20,000 have a transient ischaemic attack (TIA).
Vaginal thrush (Candidiasis)
Training for nurses improves care for women
Many advanced nurse practitioners (ANPs) are working in innovative ways to enhance patient care in general practice. But little specific training has been available for ANPs in women’s health. This article outlines how a training course was developed specifically to improve and maintain local ANPs’ competencies in managing women’s health in primary care.
The Forum takes action as the voice for women
The Primary Care Women’s Health Forum is now over one year old. When we met to establish the Forum, we set ourselves several aims and objectives. As we celebrate our first anniversary, our membership continues to grow and we are beginning to deliver on our major objectives: to be the voice for women and improve their healthcare.
Take a sexual history in primary care
Many primary care clinicians worry about how to take an appropriate sexual history. Raising the issue seems straightforward when a woman has symptoms or when contraception or cervical screening feature in a consultation. The challenge occurs when the possibility of sexual health issues may not be so apparent to the patient.
PCOS or overweight? Solving the diagnostic dilemma
Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy, affecting 5-12% of women. Every aspect has been controversial from its nomenclature to its management. But accurate diagnosis based on consensus guidelines ensures that treatment can be tailored effectively to each woman’s symptoms and needs.
Older people and HIV: A call to action
Thanks to effective treatment, people with HIV are living longer than ever. Older people are now the fastest growing group with HIV in the UK, and as many as one in five adults accessing care is now aged over 50 years. But treatment does not mean cure, and a targeted approach to support is needed, as well as action to halt the growing numbers of older women and men affected by HIV.
Intrauterine system: informed choice for women and GPs
The intrauterine system (IUS) is a very effective long-acting reversible contraceptive (LARC) for appropriate women. But myths and misconceptions may cause some patients to opt for other, less reliable or suitable methods. Addressing frequently asked questions will help GPs to prescribe with confidence and enable women to make informed decisions about their contraception.
