DoH stroke plan queried by cardiovascular GPs

DoH proposals to help reduce the number of strokes in England have been criticised by leading cardiovascular GPs.

The DoH recommends that statin therapy should be given to all patients at risk of a stroke and that warfarin should be given to patients with AF.

The proposals form part of a number of action plans set out in the DoH's 10-year national stroke strategy, which was announced last week.

The £105 million strategy aims to speed up the emergency response to stroke, by improving access to MRI scans and raising awareness about symptoms and risk factors.

The strategy states that access to MRI scans will be provided for all high-risk individuals with TIAs within 24 hours of experiencing symptoms and within seven days for low-risk individuals.

It is estimated that this could lead to an 80 per cent reduction in the number of people who go on to have a full stroke.

Surrey GP Dr John Pittard, a member of the Primary Care Cardiovascular Society questioned giving warfarin to AF patients.

'Warfarin does benefit patients with AF but many of them are reluctant to go on warfarin because of the complications associated with its use.

'It is a high-maintenance drug that requires a lot of blood test monitoring. It will also be difficult for patients to maintain the correct dosage levels especially after a stroke,' said Dr Pittard.

The strategy also reiterated advice for 'statin therapy for all people with more than a 20 per cent risk of cardiovascular disease within 10 years'.

RCGP vice chairman Dr Graham Archard said 'blanket coverage' of statin use for all patients would not be beneficial.

'I can understand the logic behind the proposal but there is no hard evidence to suggest that it will work.

'There is no evidence that people over the age of 80 will benefit from statin therapy.'

They should give statins to patients based on improvements in life expectancy, he said.

The National Stroke Strategy 2007

DoH stroke plan
  • Statin therapy given to all patients at risk of stroke.
  • Warfarin given to patients with AF.
  • Access to MRI scans for high-risk individuals with TIAs within 24 hours of symptoms and within seven days for low-risk individuals.

Source: DoH



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