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Better prescribing could prevent thousands of strokes

Improving the prescribing of anticoagulants, lipid-lowerers and antihypertensives in primary care could prevent about 12,000 first strokes a year in the UK, a new analysis estimates.

Researchers analysed a primary care database and identified 29,043 adults (median age 74 years) who had experienced their first stroke or transient ischaemic attack (TIA). Of these, 61 per cent had a clinical indication for at least one of the following: anticoagulants, lipid-lowerers and antihypertensives.

At least one of these was not prescribed when clinically indicated in 54 per cent of stroke and TIA patients.

Specifically, 52 per cent were not prescribed anticoagulants when indicated, 49 per cent were not prescribed lipid-lowerers and 25 per cent antihypertensives.

Extrapolating the findings across the UK suggests that 41,405 patients who experience a first stroke were eligible for, but not prescribed, lipid-lowerers, anticoagulants or antihypertensives.

“These findings suggest a number of missed opportunities,” says study author Grace Turner from the University of Birmingham. “Optimal prescribing could prevent an estimated 11,823 first strokes a year.”

PLoS Med doi: 10.1371/journal.pmed.1002169

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