Atrial fibrillation (Afib) is a common condition affecting a huge percentage of the population. The condition causes fast and erratic heartbeat involving the upper chamber of the heart. Statistically, people with this condition are five times more likely to have a stroke. This is because Afib interferes with the blood flow in the heart chamber which leads to blood clots. If clots form in the heart, they can travel through the blood vessels to anywhere else in the body. If one lodges itself somewhere in a small blood vessel in the brain, it will cause a stroke. That’s why stroke prevention should be the main aim of managing atrial fibrillation. This article, therefore, discusses different ways of preventing stroke when you have Afib.
Doctors prescribe many medicines to prevent a stroke, frequently referred to as anticoagulants or blood thinners. Their primary purpose is to stop any possible blood clot in your blood vessels. The most common anticoagulant medicines are warfarin (i.e. Coumadin) and aspirin. Aspirin is not highly recommended to people with atrial fibrillation because it’s not very effective. Warfarin has been in use for more than 60 years; it’s strong and effective, however, it’s also a difficult drug to take since it interacts with other drugs, foods, alcohol, vitamins and some supplements. Other than that, it requires frequent blood tests (INR tests) to help adjust doses appropriately. The blood tests are crucial for calculating how much warfarin should be in each dose. Too little warfarin usage puts you at risk of blood clots, and too much puts you at risk of bleeding.
Newer anticoagulant medicines have been developed to replace warfarin; they have less interaction with other foods and drugs and they do not need INR tests. However, it’s important to understand that not everyone will need a strong anticoagulant such as warfarin. A health provider will determine the anticoagulant medicine you will need depending on your stroke risk factors. For elderly individuals, warfarin has an unpredictable response. In addition to age and your underlying heart condition, gender has its effects on the needed warfarin dose or other alternatives. The health provider will recommend aspirin or other blood thinners depending on your risk factors and other reasons that may trigger a stroke or other blood clots.
Managing Other Conditions that Increase Risk of a Stroke
Afib commonly co-exists with other multiple conditions that can contribute to the risk of stroke themselves, for instance, high blood pressure, diabetes, sleep apnea, thyroid disease, and other heart conditions. Heart disease is also associated with kidney dysfunction and atrial fibrillation. Managing these conditions is the first step towards reducing the risk of stroke for those with atrial fibrillation. When any drug is prescribed, physicians must consider all the conditions mentioned above.
Sometimes a patient may have a very high risk of stroke from these conditions, but the risk of bleeding is greater that the risk of stroke when using a blood thinner. In such cases, doctors determine other alternatives as a blood thinner cannot be used. Of course, they will consider the bleeding consistency factors before they make such decisions. If you’ve had a stroke or you’ve already had bleeding problems, or you are older than 65 years, or maybe you drink too much (8 alcohol beverages in a week) then your bleeding risk is high, and doctors will need to consider those when they administer any blood thinner or antiplatelet.
Being Aggressive When It Comes to Stroke Prevention
Some alternative therapies can help improve the prevention of stroke in patients with afib when combined with the available medicines; there are also new and emerging treatments that have positive indication when it comes to mild and severe stroke prevention but physicians need to be diligent in using them. Even though blood thinners like warfarin are termed to be highly efficient when it comes to stroke prevention, from systematic reviews of clinical trials, it’s still important to be diligent whether it will provide benefits to a particular patient. Some people may refuse to take warfarin or other blood thinners for personal reasons (often because of previous experiences with the drug), or need of diet change, but if their risk factor indicates that warfarin will have a positive effect, it should be a recommendation, even if they don’t decide to use it.
Patients with atrial fibrillation should seek treatment with drugs or any other possible strategies that can control the abnormal heart rhythm or reduce the risk of blood clots, hence reducing the risk of stroke. Warfarin has been termed to be effective through clinical trials and practices, but the physician should determine whether they will be sufficient to an individual patient and recommend for alternatives.