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Annual risk increase for stroke= inevitable stroke?

wilsond profile image
38 Replies

Hello all

On another post yesterday it was mentioned that the annual risk of stroke goes up. I have tried looking for posts on this but the search button doesn't seem to be working today!

Forgive me for being thick but surely if you have AF for some time,eventually the risk will get to 100%? If we take anticoagulants I was told by my GP that my stroke risk was that of a " normal" person,slightly elevated.

I'm a bit low at the moment,winter blues I think following lengthy Ill period,and this is preying on my mind a little.

I'd be grateful for any clarification...using simple language and crayons if possible !

Hope we are all ok this gloomy Thursday. I have had nightime AF for a few days,early hours . So am considering ringing arrthymia nurse to see if I need to take Flec. As daily dose rather than PIP as I'm not aware straight away that it's setting off.

Normally quite settled but think it's the aftermath of a rather poorly few weeks post norovirus.

But lighter nights are coming! Xx

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wilsond
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38 Replies

You can calculate your stroke risk using this online calculator. Risk is calculated over a given period of time which you can specify.

qstroke.org/

in reply to

Here is the formula to use if you want to do a manual calculation:

Probability of a stroke in 1 year = p , say. Then Pr( NO stroke in 1 year) = 1 - p. Pr(NO stroke in 2 years) = (1 - p)(1 - p) [ years are independent] = (1 - p)**2. For 3 years (1 -p)**3, etc. For t years Pr( NO stroke) = (1 - p)**t. So, for t years Pr(stroke)=1 - (1 - p)**t. In case we have p = 0.03 p, so 1 - p = 0.97. The formula works for fractional values of t too, so for 2 weeks t = 1/26. So for 2 weeks Pr(stroke) = 1 - 0.97**(1/26). Use a calculator to find it.

CDreamer profile image
CDreamer in reply to

That one gave me 8.7% whereas other algorithms gave me 15%?!

in reply toCDreamer

One of the calculators may include more up-to-date information on the risk?

in reply toCDreamer

I tried another calculator (for those with AF) and got a *high* stroke risk. However this was based on an age of 65 (I am not actually 65 for another 5 weeks). When I put in my real age of 64, I got a *moderate* stroke risk.

cardiosmart.org/Tools/Strok...

CDreamer profile image
CDreamer in reply to

I think that just illustrates just how ‘broad stroke’ these calculation tools are!

in reply toCDreamer

It’s probably safest to take the worst estimate and err on the side of caution.

baba profile image
baba in reply to

"Welcome to the QStroke®-2018 risk calculator: qstroke.org

This calculator is only valid if you do not already have a diagnosis of stroke or TIA and are not on anticoagulants"

in reply tobaba

Thanks for pointing that out. Assuming wilsond hasn’t already had a stroke he could take the result from the calculator as an upper limit if he is on an anticoagulant.

wilsond profile image
wilsond in reply to

Hi Sam I'm a she and not had a stroke ....thank you for your advice xxx

in reply towilsond

Apologies!

wilsond profile image
wilsond in reply to

Lol! No worries!

wilsond profile image
wilsond in reply to

Thank you Sam appreciated xx

Rienij70 profile image
Rienij70

Good morning Wilsond, Sorry to see you in the dumps. I don’t know the answer to your question.

I suppose the risk of having strokes increases with age as well as having AF. As you say you need a few sunny days to cheer you up. Everyone feels down at the moment.

Bugs hugs coming your way.

Love from Rienij 🤗🤗💕

CDreamer profile image
CDreamer

I’m not a statistician so can’t oblige but I do remember years ago - I think it was Beancounter - who spelled it out. The risk creeps up rather than rises dramatically and increases once you are over 65 so age plays a part + any co-morbidities - which I am sure you know.

My initial risk factor was calculated originally by my GP from an app and stated to be no higher than the average member of the population, even with AF - which I think was about 10%. Now 13 years on, having exceeded 65 and collected a few more things wrong with me my risk has gone up to about 15%. All that means, as I understand it, is that within the population of people in similar circumstances about 15% of people will suffer a stroke. It is not a personal risk.

I am sure someone with statistical knowledge may jump in here and be able to explain but all I can say is risks are calculated by Actuaries who are incredibly brainy statisticians who are looking at risks of populations for forecasting health services required etc so are incredibly difficult to translate into personal forecasting.

For AF patients the recommended calc is CHADS as you know, but there are others such QSTOKE and everyone of them will give you a different % risk factor.

Reminds me of the old adage - there are lies, dammed lies and statistics!

wilsond profile image
wilsond in reply toCDreamer

That's a true saying! Numbers have always foxed me...letters and words are fine! I appreciate your reply ,puts things a bit clearer,thank you. X

BobD profile image
BobDVolunteer

Sorry that was my fault ! I think the point is that AF makes us five times more likely to have a stroke than a person without AF regardless of CHADSVASC which merely adds co morbidities such as diebetes, high blood pressure and prior stroke episodes as well as age which naturally inccreases risk. .(There is currently a little doubt in some quarters regarding being female). This is what is usually quoted in most publications on the subject.

Do remember that anticoagulation is considered to reduce any stroke risk by about 70%.

Whilst on the subject of CHADSVASC I would also like to mention HASBLED which is often quoted as being shall we say an "offset score" to balance against CHADSVASC. It was explained a few years ago at HRC that is is not the case. HASBLED should be used as an aide memoir of things to address before giving anticoagaulation where possible but not as a weapon to justify NOT giving it.

Sorry to read you are down to which I really can relate. An amusing poem I came across on FB

30 days has September

April June and November

February has 28 clear

Except in every leap year.

All the rest have 31 except

January which has 3423 days.

feels like it

Bob

wilsond profile image
wilsond in reply toBobD

Oh Bob you always my make me smile! Thank you for the additional information. So any annual risk is potentially reduced by 70% .....that's why I'll fight tooth nail and feet to keep my anticoagulants! Xx

Buffafly profile image
Buffafly in reply towilsond

I long ago discovered a new disease - 'Februaryitis' - caused by winter ailments, gloomy weather, Christmas chocs all eaten, nothing except beginning of Lent 😒 and spring cleaning to look forward to ...... You just got it early 🙄

wilsond profile image
wilsond in reply toBuffafly

🙄that explains it Buffafly!!

sotolol profile image
sotolol in reply toBuffafly

The sun is showing dust and smeary windows I just want to watch paint dry but I need to paint the hall walls first. I have acute Februaryitis.

in reply toBobD

Good info on January, I always suspected something like that!!! 🌬❄️⛄️

CDreamer profile image
CDreamer

I’m with you on winter blues - I’ve had inflammatory reactions following a persistent cough for 2 months now and looking out the window the day is grey and foggy - ugh! Doesn’t help does it?

Hope you feel better - I do think AF can get you down. My philosophy is as long as I have done everything in my power to keep myself well and active and taken sensible precautions such as anticoagulants to lessen my risk, then there is nothing more I can do so go enjoy every moment of what I do have.

As you know I was immobilised for quite a while with Myasthenia and it is since then I have been determined to be thankful for every day ‘I CAN’ - good incentive to make them most of life.

doodle68 profile image
doodle68

Hi Wilson :-) sorry you are feeling down not surprising considering that you have been ill and the dark days of winter. Chin up girl ! :-)

I try not to dwell on my stroke risk, that way lies maddness instead I concentrate on being as fit as I can to give my body the best possible chance of keeping illnesses at bay.

I can't change some of my existing health problems so no point in worrying about them , I have had an early warning with AF that many don't get which has allowed me to change my ways for the better while I still can :-)

Finvola profile image
Finvola

So sorry you are feeling down after your illness and these dark days just tend to make things so much worse. My husband keeps an eye on the daylight length figures and announces regularly on how much longer today is campared with the shortest day!! Doesn’t help much with cold, wet January days, though.

I agree wholeheartedly with doodle68 in living life, mitigating what risks you can and accepting the rest. This time of year does get us down - I bought some daffodils and the joy of seeing them burst into flower and perfume the room was a real good lift.

wilsond profile image
wilsond in reply toFinvola

Thank you Finvola! Been to a dance class first time today...for over 50s...hilarious as we were all pretty useless.Laughter,the best medicine?!!! Xxx

Bagrat profile image
Bagrat

These damp grey days do not cheer and I'm sorry they are getting you down along with your other issues.

All we can do is be the best we can be today. Tomorrow we may be better or worse but nothing stays the same which I find very reassuring for some bizarre reason.

I felt lousy last night but today I'm better. That seems to be how it goes.

wilsond profile image
wilsond in reply toBagrat

Thank you Bagrat! Sorry you been off colour too,glad better day now. Even frost would be welcome if the sky was blue....take care xxx

Dawsonmackay profile image
Dawsonmackay

Hey Wilsond, another member asked almost the same question but in a different way this past week and received a ton of responses: healthunlocked.com/afassoci...

TamlaMotown profile image
TamlaMotown

Hi WilsonD, here's some flowers to cheer you up a little 💐

It was my 65th birthday yesterday...quite depressing in itself without the winter blues but I had my lovely NHS birthday present to open...Apixaban!! 🤔

AF just keeps on giving 🙄

wilsond profile image
wilsond in reply toTamlaMotown

Aw thank you Tamla! Lovely and happy birthday for yesterday!! All the best xxx🎉

jeanjeannie50 profile image
jeanjeannie50

Hi my lovely friend, sorry to hear you've gone through a rough patch with your health.

Yes, the weather can be a little wearing when it rains day after day at this time of year. However, I think a little differently to everyone else as I see these dull days as cosy ones, where I can relax and pander to my lazyitis. I often meet up with friends for coffee in the morning and then watch a nice film, or read a book in the afternoon. Always have a nice dinner in the evening too, there's nothing like a tasty meal to cheer you up! In the summer months I work tending my garden and hardly watch t.v. Thank heavens I have that to do or the lazyitis could continue. Then there's also the day trips out in the sunshine, just think that lovely weather is up ahead and will soon be here. Summer months are quite hectic at times aren't they? I love these lazy, dark and dismal days. In fact I enjoy every season and think we're lucky to have the variety.

Re a stroke - well I'm hoping I'll never have one. I eat healthily and tell myself that will protect me (ok so I have just eaten two crumpets, soaked with butter - we'll ignore that)! You know we can think whatever we like, we are in charge of our brains and thoughts.

Come on gal, get that happy head on and count your blessings. I'm guessing you have a warm home to live in and enough to eat. We are the lucky ones in this world, let's rejoice because of that.

Sending a big hug your way. PM me any time, I'll try not to be a smarty pants.

Jean x

wilsond profile image
wilsond in reply tojeanjeannie50

Oh Jean.....thank you lovely lady for your encouragement and humour! I do love reading a lot in winter.

I struggle a bit for company as I retired much earlier than my friends...but am taking steps to address that.

Feeling more positive already..think I just got into the doldrums unlike me usually.

Take care dear friend too ..keep up the lazyitis! Xx

jeanjeannie50 profile image
jeanjeannie50 in reply towilsond

I volunteer as a room guide for a beautiful National Trust property. It gets me out on a Sunday, which I find to be the most boring day of the week. They don't mind how long I sit down for when on duty. I've made lots of lovely friends there and it has perks, free membership, 20% off in the NT shops and on holiday accommodation. Also a free summer barbecue, coach trip, Christmas lunch etc. There are lots of other volunteering opportunities out there. I also belong to a local history group which concentrates on the area where I live.

Think about what you're interested in and then find out where you can go to feed that interest.

Jean x

wilsond profile image
wilsond in reply tojeanjeannie50

I have been food shopping today in our local little town. Saw a poster about a new Roman and Boudicca permanent exhibition opening soon...asking for volunteers! Have ring them already. You read my mind Jean!

I think my Eyeore mood came in slowly,poorly and infectious meant no visitors ..hubby works v long hours ( lucky to have him I know) gloomy weather and irritated that dormant AF has teared its head...difficult to get advice ref meds until I banged some tables ...down the phone but you get the idea!

Thank you for your thoughtful support Jean xx

Steve101 profile image
Steve101

I’m a worrier too!

We need to change our attitude. If you are taking your anticoagulants, doing some exercise, watching your weight and eating reasonably well, what more can you do?

What will be - will be. Worrying makes us more miserable! I know it’s easier said than done, and I wish I didn’t worry as much as I do!

It’s a habit that I’m trying to get out of!

Best wishes my friend, Let’s together get into better habits, focus on what’s good in life, not the negatives.

Steve :-)

wilsond profile image
wilsond in reply toSteve101

Yes...come on lad!! Xx

secondtry profile image
secondtry

I wanted to take PIP Flecainide in the early days but my cardiologist said better to take it regularly; as PIP is too much of a roller coaster for the heart if you are having a few episodes.

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