A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland
Objective: To examine the epidemiology, primary care burden and treatment of atrial fibrillation (AF). Design: Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002. Setting: 55 primary care practices (3...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2007-05, Vol.93 (5), p.606-612 |
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| creator | Murphy, Niamh F Simpson, Colin R Jhund, Pardeep S Stewart, Simon Kirkpatrick, Michelle Chalmers, Jim MacIntyre, Kate McMurray, John J V |
| description | Objective: To examine the epidemiology, primary care burden and treatment of atrial fibrillation (AF). Design: Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002. Setting: 55 primary care practices (362 155 patients). Participants: 3135 patients with AF. Results: The prevalence of AF in Scotland was 9.4/1000 in men and 7.9/1000 in women (p85 years). The prevalence of AF decreased with increasing socioeconomic deprivation (9.2/1000 least deprived and 7.5/1000 most deprived category, p = 0.02 for trend). 71% of patients with AF received rate-controlling medication: β-blocker 28%, rate-limiting calcium-channel blocker 42% and digoxin 43%. 42% of patients received warfarin, 44% received aspirin and 78% receeved more than one of these. Multivariable analysis showed that men and women aged ⩾75 years were more likely (than those aged |
| doi_str_mv | 10.1136/hrt.2006.107573 |
| format | Article |
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Design: Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002. Setting: 55 primary care practices (362 155 patients). Participants: 3135 patients with AF. Results: The prevalence of AF in Scotland was 9.4/1000 in men and 7.9/1000 in women (p<0.001) and increased with age (to 71/1000 in individuals aged >85 years). The prevalence of AF decreased with increasing socioeconomic deprivation (9.2/1000 least deprived and 7.5/1000 most deprived category, p = 0.02 for trend). 71% of patients with AF received rate-controlling medication: β-blocker 28%, rate-limiting calcium-channel blocker 42% and digoxin 43%. 42% of patients received warfarin, 44% received aspirin and 78% receeved more than one of these. Multivariable analysis showed that men and women aged ⩾75 years were more likely (than those aged <75 years) to be prescribed digoxin (men OR 1.41, 95% CI 1.14 to 1.74; women OR 1.88, 95% CI 1.50 to 2.37) and aspirin (2.04, 1.66 to 2.51; 1.79, 1.42 to 2.25) and less likely to receive an antiarrhythmic drug (0.62, 0.48 to 0.81; 0.52, 0.39 to 0.70) or warfarin (0.74, 0.60 to 0.91; 0.58, 0.46 to 0.73). Adjusted analysis showed no socioeconomic gradient in prescribing. Conclusions: AF is a common condition, more so in men than in women. Deprived individuals are less likely to have AF, a finding raising concerns about socioeconomic gradients in detection and prognosis. Recommended treatments for AF were underused in women and older people. This is of particular concern, given the current trends in population demographics and the evidence that both groups are at higher risk of stroke.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.2006.107573</identifier><identifier>PMID: 17277353</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Adult ; Age Distribution ; Age groups ; Aged ; Angina Pectoris - epidemiology ; Anti-Arrhythmia Agents - therapeutic use ; atrial fibrillation ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - epidemiology ; Biological and medical sciences ; calcium-channel blockers ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular disease ; CCBs ; CMR ; continuous morbidity recording ; Epidemiology ; Female ; Gender differences ; General Practice Research Database ; general practitioner ; GPRD ; Health Surveys ; Heart ; heart failure ; Heart Failure - epidemiology ; Hospitals ; Humans ; Incidence ; Male ; Medical prognosis ; Medical sciences ; Mens health ; Middle Aged ; Morbidity ; Mortality ; Multivariate Analysis ; Older people ; Patients ; Population ; Prevalence ; Scotland - epidemiology ; Sex Distribution ; Socioeconomic Factors ; Womens health</subject><ispartof>Heart (British Cardiac Society), 2007-05, Vol.93 (5), p.606-612</ispartof><rights>Copyright 2007 by Heart</rights><rights>2007 INIST-CNRS</rights><rights>Copyright: 2007 Copyright 2007 by Heart</rights><rights>Copyright © 2007 BMJ Publishing Group and British Cardiovascular Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b588t-457ef5d97be137d561ca73c9194f8f3c481537c1abcd9b87f5a45fd4e60f7f7b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/93/5/606.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/93/5/606.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,724,777,781,882,3183,23552,27905,27906,53772,53774,77349,77380</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18687520$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17277353$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murphy, Niamh F</creatorcontrib><creatorcontrib>Simpson, Colin R</creatorcontrib><creatorcontrib>Jhund, Pardeep S</creatorcontrib><creatorcontrib>Stewart, Simon</creatorcontrib><creatorcontrib>Kirkpatrick, Michelle</creatorcontrib><creatorcontrib>Chalmers, Jim</creatorcontrib><creatorcontrib>MacIntyre, Kate</creatorcontrib><creatorcontrib>McMurray, John J V</creatorcontrib><title>A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>Objective: To examine the epidemiology, primary care burden and treatment of atrial fibrillation (AF). Design: Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002. Setting: 55 primary care practices (362 155 patients). Participants: 3135 patients with AF. Results: The prevalence of AF in Scotland was 9.4/1000 in men and 7.9/1000 in women (p<0.001) and increased with age (to 71/1000 in individuals aged >85 years). The prevalence of AF decreased with increasing socioeconomic deprivation (9.2/1000 least deprived and 7.5/1000 most deprived category, p = 0.02 for trend). 71% of patients with AF received rate-controlling medication: β-blocker 28%, rate-limiting calcium-channel blocker 42% and digoxin 43%. 42% of patients received warfarin, 44% received aspirin and 78% receeved more than one of these. Multivariable analysis showed that men and women aged ⩾75 years were more likely (than those aged <75 years) to be prescribed digoxin (men OR 1.41, 95% CI 1.14 to 1.74; women OR 1.88, 95% CI 1.50 to 2.37) and aspirin (2.04, 1.66 to 2.51; 1.79, 1.42 to 2.25) and less likely to receive an antiarrhythmic drug (0.62, 0.48 to 0.81; 0.52, 0.39 to 0.70) or warfarin (0.74, 0.60 to 0.91; 0.58, 0.46 to 0.73). Adjusted analysis showed no socioeconomic gradient in prescribing. Conclusions: AF is a common condition, more so in men than in women. Deprived individuals are less likely to have AF, a finding raising concerns about socioeconomic gradients in detection and prognosis. Recommended treatments for AF were underused in women and older people. This is of particular concern, given the current trends in population demographics and the evidence that both groups are at higher risk of stroke.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Age groups</subject><subject>Aged</subject><subject>Angina Pectoris - epidemiology</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Biological and medical sciences</subject><subject>calcium-channel blockers</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>CCBs</subject><subject>CMR</subject><subject>continuous morbidity recording</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gender differences</subject><subject>General Practice Research Database</subject><subject>general practitioner</subject><subject>GPRD</subject><subject>Health Surveys</subject><subject>Heart</subject><subject>heart failure</subject><subject>Heart Failure - epidemiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Mens health</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Older people</subject><subject>Patients</subject><subject>Population</subject><subject>Prevalence</subject><subject>Scotland - epidemiology</subject><subject>Sex Distribution</subject><subject>Socioeconomic Factors</subject><subject>Womens health</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc-L1DAUx4so7rp69iYB0YPY2WTS_OhFWIZdFQZFHGVvIU0TJ2PbjEk6uP-9b2zZVS_mkkfe5335vnyL4inBC0IoP9_GvFhizBcECyboveKUVFyWS0yu70NNGSs5puKkeJTSDmNc1ZI_LE6IWApBGT0t8gUadPZh0B1KYzzYGxQcyluL9tEedGcHY18jPxjfTuU--l7HG2R0tKgZIzwjPbQoR6tzb4d8nNc5ehB0vom-637rgwb6bELuAH5cPHC6S_bJfJ8VX64uN6t35frj2_eri3XZMClzWTFhHWtr0VhCRcs4MVpQU5O6ctJRU0nCqDBEN6atGykc0xVzbWU5dsKJhp4Vbybd_dj0tjXgLupOzSuooL36uzP4rfoWDorUDI4EgZezQAw_Rpuy6n0yFlYabBiTEphKXskKwOf_gLswRvjUpIiQmNeEcAHU-USZGFKK1t1aIVgd81SQpzrmqaY8YeLZnxvc8XOAALyYAZ2M7lzUEFW64ySXgi0xcOXE-ZTtz9u-jt8VGBNMffi6UtdkvVpvNp8UA_7VxDf97r8ufwEiqMeC</recordid><startdate>20070501</startdate><enddate>20070501</enddate><creator>Murphy, Niamh F</creator><creator>Simpson, Colin R</creator><creator>Jhund, Pardeep S</creator><creator>Stewart, Simon</creator><creator>Kirkpatrick, Michelle</creator><creator>Chalmers, Jim</creator><creator>MacIntyre, Kate</creator><creator>McMurray, John J V</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20070501</creationdate><title>A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland</title><author>Murphy, Niamh F ; Simpson, Colin R ; Jhund, Pardeep S ; Stewart, Simon ; Kirkpatrick, Michelle ; Chalmers, Jim ; MacIntyre, Kate ; McMurray, John J V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b588t-457ef5d97be137d561ca73c9194f8f3c481537c1abcd9b87f5a45fd4e60f7f7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Age groups</topic><topic>Aged</topic><topic>Angina Pectoris - epidemiology</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Biological and medical sciences</topic><topic>calcium-channel blockers</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>CCBs</topic><topic>CMR</topic><topic>continuous morbidity recording</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gender differences</topic><topic>General Practice Research Database</topic><topic>general practitioner</topic><topic>GPRD</topic><topic>Health Surveys</topic><topic>Heart</topic><topic>heart failure</topic><topic>Heart Failure - epidemiology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Mens health</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Older people</topic><topic>Patients</topic><topic>Population</topic><topic>Prevalence</topic><topic>Scotland - epidemiology</topic><topic>Sex Distribution</topic><topic>Socioeconomic Factors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murphy, Niamh F</creatorcontrib><creatorcontrib>Simpson, Colin R</creatorcontrib><creatorcontrib>Jhund, Pardeep S</creatorcontrib><creatorcontrib>Stewart, Simon</creatorcontrib><creatorcontrib>Kirkpatrick, Michelle</creatorcontrib><creatorcontrib>Chalmers, Jim</creatorcontrib><creatorcontrib>MacIntyre, Kate</creatorcontrib><creatorcontrib>McMurray, John J V</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murphy, Niamh F</au><au>Simpson, Colin R</au><au>Jhund, Pardeep S</au><au>Stewart, Simon</au><au>Kirkpatrick, Michelle</au><au>Chalmers, Jim</au><au>MacIntyre, Kate</au><au>McMurray, John J V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2007-05-01</date><risdate>2007</risdate><volume>93</volume><issue>5</issue><spage>606</spage><epage>612</epage><pages>606-612</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>Objective: To examine the epidemiology, primary care burden and treatment of atrial fibrillation (AF). Design: Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002. Setting: 55 primary care practices (362 155 patients). Participants: 3135 patients with AF. Results: The prevalence of AF in Scotland was 9.4/1000 in men and 7.9/1000 in women (p<0.001) and increased with age (to 71/1000 in individuals aged >85 years). The prevalence of AF decreased with increasing socioeconomic deprivation (9.2/1000 least deprived and 7.5/1000 most deprived category, p = 0.02 for trend). 71% of patients with AF received rate-controlling medication: β-blocker 28%, rate-limiting calcium-channel blocker 42% and digoxin 43%. 42% of patients received warfarin, 44% received aspirin and 78% receeved more than one of these. Multivariable analysis showed that men and women aged ⩾75 years were more likely (than those aged <75 years) to be prescribed digoxin (men OR 1.41, 95% CI 1.14 to 1.74; women OR 1.88, 95% CI 1.50 to 2.37) and aspirin (2.04, 1.66 to 2.51; 1.79, 1.42 to 2.25) and less likely to receive an antiarrhythmic drug (0.62, 0.48 to 0.81; 0.52, 0.39 to 0.70) or warfarin (0.74, 0.60 to 0.91; 0.58, 0.46 to 0.73). Adjusted analysis showed no socioeconomic gradient in prescribing. Conclusions: AF is a common condition, more so in men than in women. Deprived individuals are less likely to have AF, a finding raising concerns about socioeconomic gradients in detection and prognosis. Recommended treatments for AF were underused in women and older people. This is of particular concern, given the current trends in population demographics and the evidence that both groups are at higher risk of stroke.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>17277353</pmid><doi>10.1136/hrt.2006.107573</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Distribution Age groups Aged Angina Pectoris - epidemiology Anti-Arrhythmia Agents - therapeutic use atrial fibrillation Atrial Fibrillation - drug therapy Atrial Fibrillation - epidemiology Biological and medical sciences calcium-channel blockers Cardiac arrhythmia Cardiac dysrhythmias Cardiology. Vascular system Cardiovascular disease CCBs CMR continuous morbidity recording Epidemiology Female Gender differences General Practice Research Database general practitioner GPRD Health Surveys Heart heart failure Heart Failure - epidemiology Hospitals Humans Incidence Male Medical prognosis Medical sciences Mens health Middle Aged Morbidity Mortality Multivariate Analysis Older people Patients Population Prevalence Scotland - epidemiology Sex Distribution Socioeconomic Factors Womens health |
| title | A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland |
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