A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland

Niamh F. Murphy, Colin Richard Simpson, Pardeep S. Jhund, Simon Stewart, Michelle Kirkpatrick, Jim Chalmers, Kate MacIntyre, John J. V. McMurray

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    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: ß-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.
    Original languageEnglish
    Pages (from-to)606-612
    Number of pages7
    JournalHeart
    Volume93
    Issue number5
    Early online date3 Feb 2007
    DOIs
    Publication statusPublished - May 2007

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    Scotland
    Atrial Fibrillation
    Primary Health Care
    Incidence
    Digoxin
    Warfarin
    Therapeutics
    Aspirin
    Surveys and Questionnaires
    Anti-Arrhythmia Agents
    Calcium Channel Blockers
    Epidemiology
    Stroke
    Demography
    Morbidity
    Population

    Cite this

    Murphy, N. F., Simpson, C. R., Jhund, P. S., Stewart, S., Kirkpatrick, M., Chalmers, J., ... McMurray, J. J. V. (2007). A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland. Heart, 93(5), 606-612. https://doi.org/10.1136/HRT.2006.107573

    A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland. / Murphy, Niamh F.; Simpson, Colin Richard; Jhund, Pardeep S.; Stewart, Simon; Kirkpatrick, Michelle; Chalmers, Jim; MacIntyre, Kate; McMurray, John J. V.

    In: Heart, Vol. 93, No. 5, 05.2007, p. 606-612.

    Research output: Contribution to journalArticle

    Murphy, NF, Simpson, CR, Jhund, PS, Stewart, S, Kirkpatrick, M, Chalmers, J, MacIntyre, K & McMurray, JJV 2007, 'A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland', Heart, vol. 93, no. 5, pp. 606-612. https://doi.org/10.1136/HRT.2006.107573
    Murphy, Niamh F. ; Simpson, Colin Richard ; Jhund, Pardeep S. ; Stewart, Simon ; Kirkpatrick, Michelle ; Chalmers, Jim ; MacIntyre, Kate ; McMurray, John J. V. / A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland. In: Heart. 2007 ; Vol. 93, No. 5. pp. 606-612.
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    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: {\ss}-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.",
    author = "Murphy, {Niamh F.} and Simpson, {Colin Richard} and Jhund, {Pardeep S.} and Simon Stewart and Michelle Kirkpatrick and Jim Chalmers and Kate MacIntyre and McMurray, {John J. V.}",
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    T1 - A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland

    AU - Murphy, Niamh F.

    AU - Simpson, Colin Richard

    AU - Jhund, Pardeep S.

    AU - Stewart, Simon

    AU - Kirkpatrick, Michelle

    AU - Chalmers, Jim

    AU - MacIntyre, Kate

    AU - McMurray, John J. V.

    PY - 2007/5

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    N2 - 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: ß-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.

    AB - 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: ß-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.

    U2 - 10.1136/HRT.2006.107573

    DO - 10.1136/HRT.2006.107573

    M3 - Article

    VL - 93

    SP - 606

    EP - 612

    JO - Heart

    JF - Heart

    SN - 1355-6037

    IS - 5

    ER -