Did you know that atrial fibrillation (AF) increases the risk of a stroke by 3 to 5 times? However, blood thinners such as warfarin, or other potential treatments, can protect individuals by reducing the risk of stroke. Researchers from the University of Manchester wondered if all patients, regardless of background, were receiving the same standard of care. According to Medical XPress, the researchers evaluated over 10 years of data to determine the incidence of nonvalvular atrial fibrillation in England, as well as to understand which patients were being prescribed blood thinners. Ultimately, the researchers found that racial and socioeconomic health inequities contributed to a worse standard of care for patients who were ethnic minorities or of lower income.
Interested in reading the findings? Take a look at PLoS Medicine.
What are Health Inequities?
The World Health Organization (WHO) defines health inequities as:
differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work, and age.
There are a large number of social factors and elements which shape our overall health. Where we live, our incomes, our genders, and our race may all shape our health outcomes. However, this also means that certain factors are not equitable; those who are lower-income, for example, have a more difficult time accessing adequate and quality care, medications, or specialists.
The Study
Within this particular study, researchers examined data from over 200,000 adult patients with atrial fibrillation over a 10-year period. Doctors prescribed patients either anticoagulation therapies, aspirin, or no treatment at all. Findings from the study include:
- The incidence of atrial fibrillation increased by nearly 25% over the 10-year period, with markedly higher rates in males.
- Individuals who lived in lower-income areas were 15% less likely than those in higher-income areas to be given anticoagulation treatment.
- Additionally, patients from ethnic minorities were 22-24% less likely than white individuals to receive this therapy. This meant that many individuals with nonvalvular atrial fibrillation were not able to use the best treatment option.
- More individuals were given anticoagulation treatment between the years of 2011-2015, which could correspond to changing treatment recommendations in Europe.
- Up to 18% of those in North East regions of England, and 14% in the South West regions, are believed to have no treatment given at all.
- Individuals with comorbidities such as dementia, liver diseases, a fall history, or cancer had 18-48% lower rates of anticoagulation therapy prescriptions.
Ultimately, the study found that racial and socioeconomic inequities were preventing patients from receiving adequate treatment. Therefore, the study authors say, it is necessary to address these inequities and create a more equitable future for these patients.
About Atrial Fibrillation (AF/AFib)
Atrial fibrillation refers to an irregular and often rapid heart rate which increases the risk of other health issues, such as stroke, cardiac complications, and heart failure. Altogether, there are four different forms of atrial fibrillation: occasional/paroxysmal, persistent, long-standing, and permanent. This condition occurs when chaotic electrical signals occur in the two upper chambers of the heart. Potential causes include abnormal heart valves or congenital heart defects, high blood pressure, metabolic imbalances, viral infections, sleep apnea, and coronary artery disease, among others. In some cases, atrial fibrillation can be managed with medication. Symptoms can include:
- Fatigue and general malaise/weakness
- Heart palpitations
- Exercise intolerance
- Lightheadedness and/or dizziness
- Chest pain
- Shortness of breath
- Confusion
