title: A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland.
abstract: OBJECTIVE
  To examine the epidemiology, primary care burden and treatment of atrial fibrillation (AF).
  
  
  METHODS
  Cross-sectional data from primary care practices participating in the Scottish Continuous Morbidity Recording scheme between April 2001 and March 2002.
  
  
  METHODS
  55 primary care practices (362 155 patients).
  
  
  METHODS
  3135 patients with AF.
  
  
  RESULTS
  The prevalence of AF in Scotland was 9.4/1000 in men and 7.9/1000 in women (p<0.001) and increased with age (to 71/1000 in individuals aged >85 years). The prevalence of AF decreased with increasing socioeconomic deprivation (9.2/1000 least deprived and 7.5/1000 most deprived category, p = 0.02 for trend). 71% of patients with AF received rate-controlling medication: beta-blocker 28%, rate-limiting calcium-channel blocker 42% and digoxin 43%. 42% of patients received warfarin, 44% received aspirin and 78% received more than one of these. Multivariable analysis showed that men and women aged > or =75 years were more likely (than those aged <75 years) to be prescribed digoxin (men OR 1.41, 95% CI 1.14 to 1.74; women OR 1.88, 95% CI 1.50 to 2.37) and aspirin (2.04, 1.66 to 2.51; 1.79, 1.42 to 2.25) and less likely to receive an antiarrhythmic drug (0.62, 0.48 to 0.81; 0.52, 0.39 to 0.70) or warfarin (0.74, 0.60 to 0.91; 0.58, 0.46 to 0.73). Adjusted analysis showed no socioeconomic gradient in prescribing.
  
  
  CONCLUSIONS
  AF is a common condition, more so in men than in women. Deprived individuals are less likely to have AF, a finding raising concerns about socioeconomic gradients in detection and prognosis. Recommended treatments for AF were underused in women and older people. This is of particular concern, given the current trends in population demographics and the evidence that both groups are at higher risk of stroke.
authors.affiliation: Department of Cardiology, Western Infirmary, Glasgow, UK.
authors.forename: Niamh F
authors.initials: NF
authors.lastname: Murphy
authors.forename: Colin R
authors.initials: CR
authors.lastname: Simpson
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.forename: Michelle
authors.initials: M
authors.lastname: Kirkpatrick
authors.forename: Jim
authors.initials: J
authors.lastname: Chalmers
authors.forename: Kate
authors.initials: K
authors.lastname: MacIntyre
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D012959:Socioeconomic Factors
chemical_list: D000889:Anti-Arrhythmia Agents