This week, researchers from the eight HCM centers comprising the Sarcomeric Human Cardiomyopathy Registry [SHARE Registry] published a paper that every HCM patient should take to heart.
The sobering findings are that overweight HCM patients have a higher incidence of obstruction, heart failure and atrial fibrillation than their normal weight counterparts. As a result of this study, the researchers suggest heightened attention to weight management and exercise in order to prevent disease-related progression and complications.
For this study, 3282 patients were divided into 3 groups according to their BMI as follows:
Normal Weight: BMI less than 25;
Preobesity group – BMI between 25 and 30;
Obesity group – BMI over 30.
The researchers found that patients considered pre-obese and obese (a whopping 3/4 or 70% of the sample size!) had a higher incidence of outflow tract (LVOT) obstruction, greater left atrial diameter and increased septal thickness. Not only were patients with a BMI greater than 25 more symptomatic, they also had higher rates of hypertension, diabetes and atrial fibrillation.
These alarming results make it clear that the development of exercise programs and the recommendation of lifestyle changes for overweight HCM patients should be a priority. In addition to general health improvement, these measures would have the added benefit of reducing obstruction and preventing strokes. The researchers also cited a 2017 study which found that exercise by HCM patients results in positive changes to peak oxygen consumption.
Attention to diet and exercise is not a new concept for HCM patients. In fact, many doctors have been strongly advocating for lifestyle changes in HCM patients.
In 2017, I had an opportunity to interview Dr. Sharlene Day and Dr. Sara Saberi (who wrote the oxygen consumption and exercise study cited above) about their groundbreaking work which showed the benefits of exercise in HCM. You can read it here.
The takeaway message for HCM patients is that getting active and watching the scale will not only benefit your heart, it will make you feel better!
HCM Beat 
The problem for many middle-aged people with HCM is that the advice regarding exercise has varied over the last few years. One cannot go and run half marathons and do triathlons, or cycle vast distances like most 40 to 60 year olds in London seem to forever be doing. We are advised against doing anything which may suddenly alter the heart rate, and I for one find it difficult to find an exercise which doesn’t start to push my heart rate up significantly. I have exercised for the last 35 years – weight-training and swimming – and continue to do these as many times a week as possible, but I have to listen to my cardiologist and remember to not overdo it. This perhaps causes many with HCM to adopt a more sedentary lifestyle than is advisable, hence the tendency for many to put on weight.
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Yes that is all true. Hopefully the new research and findings will change things.
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