1. Burden of atrial fibrillation in Māori and Pacific people in New Zealand: a cohort study.
- Author
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Gu, Yulong, Doughty, Robert N., Freedman, Ben, Kennelly, John, Warren, Jim, Harwood, Matire, Hulme, Richard, Paltridge, Chris, Teh, Ruth, Rolleston, Anna, and Walker, Natalie
- Subjects
ATRIAL fibrillation diagnosis ,STROKE risk factors ,ASIANS ,ATRIAL fibrillation ,DRUGS ,LONGITUDINAL method ,MAORI (New Zealand people) ,PATIENT compliance ,PRIMARY health care ,DISEASE prevalence ,ELECTRONIC health records - Abstract
Abstract: Background: Atrial fibrillation (AF) is a major risk factor for ischaemic stroke and cardiovascular events. In New Zealand (NZ), Māori (indigenous New Zealanders) and Pacific people experience higher rates of AF compared with non‐Māori/non‐Pacific people. Aim: To describe a primary care population with AF in NZ. Stroke risk and medication adherence according to ethnicity are also detailed. Methods: Electronic medical records for adults (≥20 years,
n = 135 840, including 19 918 Māori and 43 634 Pacific people) enrolled at 37 NZ general practices were analysed for AF diagnosis and associated medication prescription information. Results: The overall prevalence of non‐valvular AF (NVAF) in this population was 1.3% (1769), and increased with age (4.4% in people ≥55 years). Māori aged ≥55 years were more likely to be diagnosed with NVAF (7.3%) than Pacific (4.0%) and non‐Māori/non‐Pacific people (4.1%,P < 0.001). Māori and Pacific NVAF patients were diagnosed with AF 10 years earlier than non‐Māori/non‐Pacific patients (median age of diagnosis: Māori = 60 years, Pacific = 61 years, non‐Māori/non‐Pacific = 71 years,P < 0.001). Overall, 67% of NVAF patients were at high risk for stroke (CHA2 DS2 ‐VASc ≥ 2) at the time of AF diagnosis. Almost half (48%) of Māori and Pacific NVAF patients aged <65 years were at high risk for stroke, compared with 22% of non‐Māori/non‐Pacific (P < 0.001). Irrespective of ethnic group, adherence to AF medication was suboptimal in those NVAF patients with a high risk of stroke or with stroke history. Conclusion: AF screening and stroke thromboprophylaxis in Māori and Pacific people could start below the age of 65 years in NZ. [ABSTRACT FROM AUTHOR]- Published
- 2018
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