The Prevalence, Impact and Economic Implications of Atrial Fibrillation in Stroke: What Progress Has Been Made?

Abstract

Atrial fibrillation (AF) is a major risk factor for stroke, especially in the elderly. Increased life expectancies mean that AF-related stroke is a growing global public health concern. Improvements in the detection, treatment and prevention of the consequences of AF have occurred in recent years. However, the extent to which these improvements have impacted on the prevalence of AF, the risk of AF-related stroke and subsequent economic costs are unknown. This review provides a contemporary assessment of the epidemiological data on AF-related stroke aimed at assessing the effectiveness of primary prevention strategies and associated economic implications with reductions in stroke incidence. A systematic review of the literature was performed. Appropriately designed studies were identified and retrieved. Evidence on changes in the prevalence of AF, the risk of stroke associated with AF and the excess cost of AF-related stroke over the last 30 years was summarised. The results provide evidence that the age-adjusted prevalence of AF and the relative risk of stroke associated with AF has remained relatively constant. Unless action is taken to improve detection of AF and reduce its consequences, a considerable increase in the social and economic burden associated with AF-related stroke is likely.

Morning hypertension is a risk factor of macrovascular events following cerebral infarction

“…[ 42 – 45 ] In addition, some types of atrial fibrillation are vagally mediated and uncontrolled blood pressure is a risk factor for atrial fibrillation. [ 42 – 46 ] High catecholamines levels are associated with atrial fibrillation since they play important roles in the sympathetic activity and they show circadian variations. [ 47 ] Unfortunately, catecholamines could not be assessed in the present study.…”

Paroxysmal Atrial Fibrillation: Novel Strategies for Monitoring and Implications for Treatment in Stroke

“…Approximately 15-20 % of ischemic stroke patients have known atrial fibrillation (AF) [2] and even more are likely to have undetected paroxysmal atrial fibrillation (PAF) [3]. AF is often asymptomatic [4] and thus difficult to detect.…”

Trends in stroke mortality rates in Russia and the USA over a 15-year period

“…россиян. Эти заболевания ложатся тяжелым социально-экономическим бременем на общество, что обусловлено прямыми и непрямыми расходами на медико-социальную помощь пациентам и потерями в результате инвалидизации [3,4]. В 2008 г. Минздравом РФ разработан и начал реализовываться комплекс мероприятий, направленных на совершенствование медицинской помощи больным с сосудистыми заболеваниями.…”