A recent study published in the European Heart Journal by doctors from the Mayo Clinic showed that women with hypertrophic cardiomyopathy (HCM) have a statistically reduced rate of survival as compared to men with HCM.
To respond to this inequity, the doctors suggest that the medical system must improve at identifying HCM in the female patient population. Additionally, they propose a lower threshold for the referral of female patients for more advanced therapies.
The study compared by gender the data of 3673 patients (1661 women and 2012 men) who had an initial HCM evaluation at Mayo Clinic between 1975 and 2012.
The data showed that compared to men, women with HCM:
- present with the disease at an older age;
- are more likely to have the obstructive form of the disease;
- have increased diastolic dysfunction;
- are more likely to have worse cardiopulmonary exercise test results; and
- are more likely to have pulmonary hypertension.
Strikingly, a female HCM patient’s risk of dying (from any reason – not specifically HCM) was about 6% higher than that for a man over a 5 years period and approximately 11% higher over a 10 year period.
The authors suggest several possible explanations for this discrepancy:
- Genetic and endocrine differences between males and females;
- Women with HCM do not undergo cardiac screening tests with the same frequency as men and therefore go undiagnosed and untreated longer than men;
- Women are less likely to be diagnosed with HCM during routine medical exams and are more likely to be misdiagnosed with hypertension instead of being accurately diagnosed with HCM;
- Women are more likely to be on medications for other conditions which could be blamed for vague symptoms; and
- Beta-blockers, which were associated with increased survival in this study, were less likely to have been prescribed to women by their referring doctors.
Editor’s Note: As a female HCM patient who is included in this study, I can pretty confidently speak on behalf the other 1660 of us by voicing the hope that researchers identify and remedy any factors which contribute to worse outcomes in female patients. In fact, we hope for equally good outcomes for all!