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GPs undertreating AF in stroke patients

Women are more likely to die of a stroke than men, despite there being a "significant" improvement in the number of stroke incidences during the past decade, research suggests.

The study, published in the British Medical Journal Open (BMJ Open) shows 32,000 adults in the General Practice Research Database (GPRD) had a stroke during 1999 to 2008

One in seven lost their life to the attack.

Researchers found women were more likely to die of a stroke then men. The average age for a first stroke was 77 years for women and 71 years for men.

Although the prevalence of stroke rose by 12.5%, it was found that the number of new cases fell by 30% in the past ten years.

The drop was even greater (42%) among those aged 80 or over - the age group at the highest risk of stroke.

The study also concluded that the rate of deaths within 56 days of a first stroke has almost halved. The numbers fell from one in five (21%) in 1999 to nearly one in ten (12%) in 2008.

Despite such improvements being linked to better stroke prevention by primary care doctors, researchers found they are still undertreating "one of the major risk factors" in stroke patients - atrial fibrillation (AF).

Around one in 10 patients studied were diagnosed with AF before their first stroke, and this group were deemed to be "at significantly higher risk of death from stroke" than those who did not have AF.

"But only one in four of all those with AF were prescribed preventive anticoagulant (blood thinning) treatment, with no sign that more serious AF was being targeted," said the authors.

Women were "significantly more likely" to have serious AF than men, but they were less likely to be given anticoagulant therapy.

This was prescribed for 29% of men with AF, but only 22% of women. 

The authors conclude that primary care doctors are tackling the risk factors for stroke much more effectively.

"However, there is a clear suggestion that risk stratification is not yet optimal, particularly in relation to patients with AF," they write.

British Medical Journal