Heart and Stroke Foundation report reveals: Up to a quarter of a million Canadians with irregular heartbeat five times more likely to have a stroke - and twice as likely to die from one



    OTTAWA, June 10 /CNW Telbec/ - According to the Heart and Stroke
Foundation, 250,000 Canadians currently diagnosed with the most common type of
heart arrhythmia - atrial fibrillation (AF) - are at least five times more at
risk to have a stroke and twice as likely to die from one. More worrisome is
that the vast majority may not be aware of their stroke risk.(1)
    "Complicating matters, many Canadians are not being properly treated for
the condition in the first place," says Dr. Paul Dorian, Heart and Stroke
Foundation spokesperson and cardiologist.
    "Up to 15 percent of strokes are caused by AF," adds Dr. Dorian. "In
people over the age of 60, that number increases to about one-third of
strokes."
    Atrial fibrillation (AF), a type of irregular heart rhythm known as an
arrhythmia, can cause the heart to beat very fast, sometimes more than 150
beats per minute. While it is rare in people under 40, its prevalence
increases with age. After the age of 55, the incidence of AF doubles with each
decade of life and with other risk factors for heart disease and stroke
including high blood pressure, diabetes and underlying heart disease.
    "Stroke places a tremendous burden on our society. When AF patients have
a stroke, the impact becomes even more profound," says Dr. Marco Di Buono,
director of research, Heart and Stroke Foundation of Ontario. "These patients
are reported to stay in hospital longer, have increased disability, and are
more likely to have recurrent strokes."(2/3)

    A WAKE-UP CALL

    "The most important medical advance in the past decade is the
effectiveness of blood thinners in managing AF and the risk of having a
stroke," says Dr. Dorian. "Yet, it is extremely disturbing that only a small
percentage of at-risk patients are actually prescribed these life saving
treatments."
    Most Canadians living with AF manage their condition by following a
healthy lifestyle and taking prescribed medication. While warfarin is the most
commonly prescribed medication for reducing stroke risk in the AF patient, its
use in Canada by people age 65 and older with the condition remains below 50
per cent.4 The use of anticoagulants such as warfarin prevent clots from
forming in the heart and travelling to the brain.
    "Clinical guidelines are in place but there is a need for healthcare
practitioners to be aware of the condition's risks and put the treatment
options into practice," says Dr. Di Buono. "Further, people with AF should
talk to their healthcare providers about their stroke risk and what they can
do about it."
    According to the Heart and Stroke Foundation, a growing body of evidence
suggests that AF patients can be better categorized based on their risk for
developing stroke as a means of identifying the appropriate therapy. For
example, the elderly, those with a previous stroke or TIA (mini stroke), and
patients with high blood pressure, diabetes, or heart failure are all at
greater risk of suffering from a stroke after being diagnosed with atrial
fibrillation.

    
    The CHADS(2) Index is a simple tool used by many healthcare providers to
determine stroke risk:

    -------------------------------------------------------------------------
                                 Risk Criteria                        Points
    -------------------------------------------------------------------------
    C                      CONGESTIVE HEART FAILURE                        1
    -------------------------------------------------------------------------
    H                   Hypertension (high blood pressure)                 1
    -------------------------------------------------------------------------
    A                     Age (greater than 75 years)                      1
    -------------------------------------------------------------------------
    D                              Diabetes                                1
    -------------------------------------------------------------------------
    S                 Stroke or transient ischemic attack (TIA)            2
    -------------------------------------------------------------------------
    

    How the CHADS(2) Index works: one point is given for each risk condition
(age, high blood pressure, diabetes, congestive heart failure). A previous
stroke or TIA adds two points to a patients score. The greater the score, the
greater the risk of developing stroke. A patient with a score of 0 would have
an annual risk of stroke of about 1.9%. The patient with a score of 6 would
have about 18% annual risk of stroke.
    "Bottom line - stroke is a medical emergency and we know the AF patient
is at increased risk of stroke, says Dr. Dorian. "All Canadians, AF patients
especially, should know how to recognize and react to stroke warning signs if
needed."

    WHAT IS THE HEART AND STROKE FOUNDATION DOING?

    The Heart and Stroke Foundation is concerned about the high incidence of
stroke, its impact and economic burden, and has taken a number of steps to
address this issue, including:

    
      -  Leading the Canadian Stroke Strategy with the Canadian Stroke
         Network. This initiative is designed to provide all Canadians with
         the best stroke care possible, regardless of where they live, by
         2010.

      -  Calling for better surveillance data on stroke. Accurate, timely,
         accessible information is essential to health. Patients, providers,
         managers and governments need information to guide prevention,
         improve care, and support research.  The Canadian Heart Health
         Strategy includes a recommendation to gather Canadian data on the
         prevalence and incidence of heart disease and stroke risk factors,
         diseases, and health inequalities in Canada.

      -  Coauthoring the Canadian Best Practice recommendations for Stroke
         Care (published in CMAJ, December 2008). The Consensus Panel
         participants identified recommendations that if implemented
         immediately would have the greatest impact on stroke care in Canada.
         Anticoagulation in stroke patients with atrial fibrillation was
         identified as one of the top 10 priorities.

      -  Working with the Canadian Stroke Network to organize the first
         national Canadian Stroke Congress in 2010 to address this and many
         other issues related to stroke prevention, treatment, and management

      -  Developed an informative section on atrial fibrillation on
         www.heartandstroke.ca/AF

    Heart and Stroke Foundation Recommendations

    To people with atrial fibrillation:

      -  Learn more about AF and talk to your doctor

      -  Be your own advocate - know what to ask when speaking with your
         health care provider if you are an AF patient. Every AF patient
         should ask :

           -  What is my stroke risk?

           -  What treatment should I be receiving?

           -  Tell your doctor how you're feeling and what symptoms you may
              or may not be experiencing

      -  Make sure you take your medication as prescribed and that your
         blood pressure is measured on a regular basis

      -  Visit the Heart and Stroke Foundation's website
         heartandstroke.ca/AF to find out more about atrial fibrillation

      -  Stroke is a medical emergency - if you experience any of the signs
          of stroke call 9-1-1 or your local emergency number. Signs include:

           Weakness - Sudden loss of strength or sudden numbness in the face,
           arm or leg, even if temporary.
           Trouble speaking - Sudden difficulty speaking or understanding or
           sudden confusion, even if temporary.
           Vision problems - Sudden trouble with vision, even if temporary.
           Headache - Sudden severe and unusual headache.
           Dizziness - Sudden loss of balance, especially with any of the
           above signs

    To healthcare practitioners:

      -  Familiarize yourself with the Canadian Cardiovascular Guidelines and
         Stroke Best Practices document and know how to determine risk of
         stroke for patients with AF and how to diagnose the AF patient

      -  Update your knowledge of, and consider use of anticoagulants and
         anticoagulation therapy in AF patients

      -  Talk to your patients with atrial fibrillation about their stroke
         risks.

    To Canadians:

      -  Healthy lifestyle changes that lower blood pressure, such as
         maintaining a normal weight and limiting salt intake and controlling
         diabetes, can help reduce the chances of developing atrial
         fibrillation

      -  If you have high blood pressure, you are at increased risk of
         developing AF and should be aware of the AF symptoms: irregular and
         fast heartbeat, heart palpitations or a rapid thumping in the
         chest, chest discomfort, chest pain or pressure, shortness of
         breath, particularly with exertion, or anxiety, fatigue, dizziness,
         sweating, nausea, lightheadedness or fainting

    Canadians can seek more information on atrial fibrillaltion and stroke on
the Heart and Stroke Foundation's website at heartandstroke.ca/AF

    The Heart and Stroke Foundation, a volunteer-based health charity, leads
in eliminating heart disease and stroke and reducing their impact through the
advancement of research and its application, the promotion of healthy living,
and advocacy.

    B-roll will be available through CNW Group - at the listed times and
co-ordinates:

    DATE OF FEED:     Wednesday, June 10, 2009

    TIME OF FEED:     11:00 am - 11:30 am ET

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    DATE OF POSTING:  June 10

    References:

    1    AF AWARE Group survey 2009 - Slightly more than 4% of patients are
         aware of the increased stroke risk that ensues with AF,  The survey
         included 75 patients per country in 11 countries (including Canada.)

    2/3  Lin H, Wolf P, Kelly-Hayes M, et al. Stroke severity in atrial
         fibrillation: The Framingham Study. Stroke 1996;27:1760-4.;
         Jorgensen HS, Nakayama H., Reith J., Raaschou HO, Olsen TS. Acute
         stroke with atrial birillation. The Copenhagen Stroke Study,
         Stroke 1998:27:1765-9.

    4    Humphries KH, Jackevisius C, Gong Y, Svensen L, Cox J, Tu JV,
         Laupacis A. Population rates of atrial fibrillation/flutter in
         Canada. Can J Cardiol 2004;20:869-76
    




For further information:

For further information: Eileen Melnick McCarthy, (613) 852-0423 (cell),
(613) 569-4361, ext. 318, emelnick@hsf.ca; Elissa Freeman, (416) 565-5605
(cell), efreeman@hsf.on.ca; Jane-Diane Fraser, (613) 569-4361, ext 273,
jfraser@hsf.ca; For provincial media contacts: see "contact us" at
www.heartandstroke.ca/media


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