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Blood Test Reveals Genetic Risk of Atrial Fibrillation and Stroke

About half of the people with AFib are seniors age 75 or older

Ischemic Stroke graphicOct. 3, 2014 – Atrial fibrillation, which causes an irregular heartbeat, can lead to a number of health risks, including heart disease and stroke. Developing AFib increases markedly with older age, with about half of those with the condition are senior citizens over age 75. The American Heart Association points out people are more likely to get the condition if a family member has it. New research, however, has discovered how to identify with a simple blood test those who are genetically predisposed to develop atrial fibrillation and possibly a stroke.

“About three out of four people who have a stroke for the first time have high blood pressure. And an irregular atrial heart rhythm - atrial fibrillation - is present in about one out of five strokes,” according to the American Heart Association.

“Stroke is the nation’s No. 4 killer. It happens when a blood vessel that supplies blood to the brain is blocked or bursts. Nearly 800,000 Americans suffer a stroke each year. High blood pressure is the chief culprit, and atrial fibrillation isn’t far behind.”

The number of people affected by atrial fibrillation is rising rapidly, partly as a result of the aging population.

 

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Over recent years, a research group at Lund University in Sweden, working with other universities and hospitals in Europe and the USA, has identified twelve genetic variants in the human genome that increase the risk of atrial fibrillation. The research group has now studied the possible clinical benefits of a DNA test:

"One in five people have a genetic weakness that means they have twice as high a risk of developing atrial fibrillation as those with a low genetic risk. This genetic risk is therefore one of the strongest risk factors for atrial fibrillation that we know of in people without overt cardiac disease. It increases the risk as much as high blood pressure, for example", said Olle Melander, Professor of Internal Medicine, and Gustav Smith, Associate Professor in Cardiology, both from Lund University.

Since the symptoms of atrial flutter can be weak and unclear, they are sometimes difficult to pick up. However, even those with weak or absent symptoms of atrial flutter are at significantly higher risk of stroke.

"In patients who are suspected of having temporary but recurrent episodes of atrial fibrillation, or in people with high blood pressure, it can be important for doctors to look at their genetic predisposition using a blood test. The test can give guidance as to how often and how intensively doctors need to screen for presence of atrial fibrillation in these individuals. We also consider that more widespread treatment of high blood pressure may be justified in those with a high genetic risk of atrial fibrillation", explained Melander.

Patients already diagnosed with atrial fibrillation were also studied, and the researchers observed that if they had the risk genes, their risk of stroke was increased by a further 70–80 per cent.

If an individual with atrial fibrillation is regarded as having a sufficiently high stroke risk, lifelong treatment with anticoagulant drugs such as warfarin is required in order to lower the risk.

"There are also benefits of checking the genetic risk of those who have already been diagnosed with atrial fibrillation. The test makes it easier to correctly assess whether anticoagulant medication is necessary to prevent stroke, especially for those under 65", said Olle Melander.

The research data was taken from a long-term follow-up of 27,400 participants in a population study.

"The present results are one of several examples of how genetics research is not only an effective way of identifying new disease mechanisms, but can also have clinical applications and help doctors and patients to decide on the right tests and treatment", said Olle Melander.

The research was funded by, among others, the Swedish Heart-Lung Foundation, the Swedish Research Council and the EU. The findings were published recently in the American journal Stroke.

About Atrial Fibrillation

An arrhythmia is a problem with the speed or rhythm of the heartbeat. Atrial fibrillation (AF) is the most common type of arrhythmia. The cause is a disorder in the heart's electrical system.

Often, people who have AF may not even feel symptoms. But you may feel

>> Palpitations -- an abnormal rapid heartbeat

>> Shortness of breath

>> Weakness or difficulty exercising

>> Chest pain

>> Dizziness or fainting

>> Fatigue

>> Confusion

AF can lead to an increased risk of stroke. In many patients, it can also cause chest pain, heart attack, or heart failure.

Doctors diagnose AF using family and medical history, a physical exam, and a test called an electrocardiogram (EKG), which looks at the electrical waves your heart makes. Treatments include medicines and procedures to restore normal rhythm.

NIH: National Heart, Lung, and Blood Institute

>> Atrial Fibrillation and Stroke (National Institute of Neurological Disorders and Stroke)

>> Device Interventions for Stroke Prevention in Atrial Fibrillation  (American Heart Association)

>> High Blood Pressure, Afib and Your Risk of Stroke (American Heart Association)

>> Stroke Prevention in Atrial Fibrillation (American Heart Association)

 

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