Stroke Prevention and Atrial Fibrillation
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Reducing the risk of stroke is vital to improving the health of older people. We research ‘funny turns’ that are a warning sign of stroke (termed ‘transient ischaemic attacks’) and the detection and treatment of major risk factors for stroke - high blood pressure and atrial fibrillation.
Stroke is the leading cause of disability in adulthood, the third leading cause of death and costs £9 billion per year in the UK. We research how primary care can contribute to stroke prevention by treating the conditions that are closely associated with stroke.
High blood pressure (hypertension) is a major risk factor for stroke. The TASMINH studies have examined how patients can reduce their blood pressure further by monitoring their own blood pressure and controlling their own medication. The HyBET study is examining how the diagnosis of hypertension can be made quickly and accurately with home measurement of blood pressure. We have also conducted systematic reviews of methods of diagnosing hypertension and studies of the best performing blood pressure machines in GP surgeries.
Patients with transient ischaemic attack (TIA), which usually involve weakness or speech, visual or sensory disturbance and come on suddenly and then spontaneously improve, are at a high risk of stroke. Accurate recognition of TIA in primary care is essential and the best ways of achieving this are being studied in RAPID-TIA and InSiST. Atrial fibrillation (AF), an irregular heart rhythm, can lead to stroke and patients with AF need to be detected and treated in primary care. The group’s systematic reviews of oral anticoagulation and self monitoring have established the evidence base for improving the primary care treatment of AF.
Researchers in the group have worked on the UK’s most important stroke prevention studies - The Oxford Vascular Study (OXVASC) and the Birmingham Atrial Fibrillation Trial (BAFTA). Our research methods include systematic reviews, intervention trials, cohort studies and diagnostic accuracy studies.