Europe remains at risk of a devastating stroke crisis, according to a major new Report, "How Can We Avoid a Stroke Crisis in Europe?" published today, on World Stroke Day, by Action for Stroke Prevention (ASP). Alarmingly, the Report highlights that the first time many people will find out they have AF is when they have a stroke. Furthermore, approximately 70% of patients with known AF who had a stroke caused by a blood clot were not receiving anticoagulant therapy to prevent AF-related stroke at the time. With stretched healthcare budgets and the annual cost of stroke in Europe at approximately €64 billion, more needs to be done to reduce the number of these serious, costly, and yet preventable strokes.
In addition to their Report, ASP has launched two supplementary Reports for healthcare decision makers and healthcare professionals respectively, that provide concrete action steps that can be taken at a community level to reduce the personal and economic impact of AF-related stroke.
Reducing a Preventable Burden: Effecting Change
"We need to ensure that AF is recognised as a serious risk factor for stroke in national prevention plans and that concrete actions are defined in these plans that support earlier diagnosis and improved awareness, education and prevention," said world-renowned Cardiology expert, John Camm, Professor of Clinical Cardiology at St George's University, London, UK. "It is our hope that national governments will address this as they plan how to meet the United Nations' commitment to reduce non-communicable diseases by 25% by the year 2025."
The critical challenge is for key parties - healthcare professionals, policy-makers, medical societies, patient advocacy groups and industry alike - to work together to reduce the burden of AF-related stroke.
Recommendations made by the Report and supporting supplementary Reports include:
improving public awareness and understanding of AF and the risk of AF-related stroke
implementing effective practice standards and targets for healthcare professionals; for example, targets for AF screening
facilitating the exchange of best practice between Member States
developing strategies to support adherence to clinical guidelines and the provision of equal and adequate administration of therapy for people with AF
Cecilia Wikström, Member of European Parliament (MEP) and a co-author of the Report's foreword commented, "I support the recommendations made by Action for Stroke Prevention and believe it is important that they are addressed in stroke, cardiovascular and non-communicable disease strategies. Their implementation will contribute to the prevention of stroke in people with AF and, in turn, reduce the dramatically increasing clinical, economic and social burden of stroke in Europe. It is important that governments and healthcare policy makers take action to ensure that diagnosis and appropriate treatment are available to all European citizens."
Lack of Knowledge Increases Risk
A new IPSOS MORI survey of 9,211 people from 20 countries across the globe has underlined the urgent need to act on Action for Stroke Prevention's recommendations. Findings in Europe highlight that whilst nearly a third (31%) of people fear having a stroke above some other serious health conditions including heart disease, diabetes and high cholesterol, 52% of people in Europe have not heard of AF. Worryingly, the survey also revealed that 85% of people in Europe are unaware that AF is a serious risk factor for stroke. Whilst 65% of Europeans identified high blood pressure as a stroke risk factor, only 15% know that AF is a risk factor for stroke, despite AF increasing the risk of stroke more than high blood pressure.
"Awareness of AF is very low and the detection and management of AF is poor," said Eve Knight, Chief Executive and Co-Founder of the Charity AntiCoagulation Europe. "If we do not act now to ensure people are diagnosed prior to a stroke and get access to treatment, including the non-Vitamin K Antagonists now available, the situation will only get worse as the number of people with AF is predicted to vastly increase."
Despite the availability of clinical practice guidelines, such as the European Society of Cardiology Guidelines on AF, adherence to them is poor and there remains a chronic under-use of effective stroke prevention therapies in AF, with several studies reporting anticoagulant use in <50% of people with AF who are at high risk of stroke.
IPSOS MORI's survey showed that, perhaps unsurprisingly, only 16% of the general public worldwide are aware that the risk of AF-related stroke can be reduced with anticoagulant treatment, demonstrating the need for education to enable patients to participate in their own healthcare decisions. The recommendations and actions identified by Action for Stroke Prevention must be initiated now, otherwise millions of more lives will be devastated by AF-related stroke.
Action for Stroke Prevention