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Research

Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k342 (Published 14 February 2018) Cite this as: BMJ 2018;360:k342

Rapid Response:

Re: Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care

Madam,

The important report from Kumar et al in your issue of 17 February on the higher incidence of ischaemic stroke in elderly patients with ‘chronic kidney disease’ (diagnosis based on estimated GFR) and recent onset of atrial fibrillation on anticoagulant prophylaxis is surprising and a bit disturbing for a reader exhibiting these criteria; however, missing is any mention of high blood pressure, which is known to be associated with both renal disease and stroke and should surely be taken into account in explaining their findings. It would be interesting to know whether renal hypertension is associated with stroke as hypertension is known to be overall.

Yours faithfully,

Professor John A Davis MD FRCP

Competing interests: No competing interests

06 March 2018
John A Davis
Professor
Great Shelford