HAS-BLED is a risk score designed to predict the one year risk for major bleeding in AF patients and may be used to aid in clinical decision making regarding anticoagulation therapy. HAS-BLED is an acronym for the bleeding risk factors that are assessed: Hypertension (uncontrolled, > 160 mm Hg systolic), Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly (age >65 years), and Drugs/alcohol concomitantly (antiplatelet agents, non-steroidal anti-inflammatory drugs). A high HAS-BLED score is associated with a high risk of hemorrhage. When used in conjunction with a stroke risk score, HAS-BLED may be able to help one weigh the stroke risk and bleeding risk to determine the best course of action for anticoagulation therapy. It is important to note however, that CHADS2 and CHADS2-VASc stroke risk scores contain some of the same risk factors as HAS-BLED. The results of the HAS-BLED score should be interpreted with this in mind.
State and local leaders have also made it clear they’re fighting the decision and will continue to fight climate change, with or without federal support. The Climate Mayors Agreement is a commitment between now 8o+ cities including Austin, Palo Alto and San Francisco to ignore Trump’s March executive order that weakened the Clean Power Plan , which would have compelled states to set power plant emissions reductions goals. They want to keep those goals intact. Several of these same cities have jointly signed onto former Mayor Bloomberg’s new plan, which is a coalition of cities, states, and companies who plan on coordinating with the UN directly to come up with carbon emissions targets.