Atrial fibrillation amongst the Indo-Asian general practice population: The West Birmingham Atrial Fibrillation Project

Abstract

Whilst there are recognised ethnic differences in cardiovascular disease, with a higher prevalence of hypertension and complications such as stroke amongst black/Afro–Caribbean populations, and ischaemic heart disease being more prevalent amongst Indo–Asians, the literature describing the clinical epidemiology of atrial fibrillation (AF) in non-caucasian groups is scarce. To survey the clinical features and management amongst Indo–Asian patients with known AF, we studied patients from six general practices in the west of Birmingham. The six general practices had a combined practice population of 25 051, from which, the Indo–Asian population was 14 670. A total of 12 Indo–Asian patients (six male, six female; mean age, 67 years; range, 42 to 95 years) with known AF were identified, suggesting a prevalence of AF in Indo–Asians aged >50 years of 0.6%. Six patients had chronic AF, two had recent onset (defined as onset <six months) and four had paroxysmal AF. Five patients had a history of ischaemic heart disease, three had hypertension, seven had heart failure, two had alcohol excess, four had mitral valve disease, and one patient with paroxysmal AF had sick sinus syndrome. None could be classified as having lone AF. Only four patients were anticoagulated, but, of the remaining eight, who were not taking warfarin, six were taking aspirin. None of the patients had contraindications to warfarin, but one of the patients who was taking aspirin had poor compliance to warfarin. In this survey of a general practice Indo–Asian population of approximately 14 670, we found 12 patients with known AF. More information on the clinical epidemiology of AF in non-caucasian groups is still needed and urgently required, in view of the public health implications of this common cardiac arrhythmia.