Soltalk February 2018 | Page 42

HealthTalk
Doctor’s notes
Dr Rik Heymans is a general practitioner in Nerja and writes on developments in the world of medicine
fibrillation (AF) according to a new study. These results are
certainly surprising, as an association between AF and falls has
not been shown in the general population before. Certain
arrhythmias are known to cause fainting or blackouts, but this
is the first study to show the link with falls, with the potential
consequences.
Gout
We start with the international treat-to-target recommendation
for managing gout. This initiative defines treatment targets
and recommendations to measure disease severity and
encourage better management. For gout, the primary goal for
treatment is to reduce serum uric acid levels to lower than 6
mg/dL and to maintain that level.
Almost 30% of those with AF had fallen during the past year,
compared to about 20% of those without AF, the researchers
reported. After statistical analysis by age, AF was significantly
associated with falls in participants aged 65-74 years especially.
The most common causes of falls are muscle weakness,
balance problems, gait problems, medication side effects,
neurological issues, dizziness, or cognitive impairment.
Three other treatment targets in the recommendations are:
* Reduce tophi (the lumps full of gout crystal which
may appear on the elbows, the earlobes, etc);
* Control pain;
* Decrease the frequency of the acute attacks.
Cardiac arrhythmias, including AF, do cause falls, but less
commonly than the other causes and risk factors mentioned;
but since the AF incidence is definitely on the rise, this will
become more and more relevant.
Patients with severe gout experiencing frequent attacks or even
tophi should aim for levels lower than 5 mg/dL. The basic
message is that gout is a chronic disease that needs clear
treatment targets and should not be ignored. Luckily we have
newer medications available which are far more effective than
the original drug allopurinol, and these, combined with dietary
measures should help patients reach the above mentioned
treatment goals.
We use a 24-hour cardiac monitoring device at our clinic,
which is an exact tool to screen for such arrhythmias.
© Dr RIK HEYMANS
c/ Angustias 24, Nerja.
Tel: [phone]
Older adults who suffer a fall
Older adults who suffer a fall are twice as likely to have atrial
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