Heart Ailment Seems Under-recognized in Women

NEW YORK (Reuters Health) - Compared to men, women with a hereditary heart condition called hypertrophic cardiomyopathy are substantially more likely to be diagnosed later in life and with more severe symptoms, an Italian study indicates.

This occurs despite the fact that hypertrophic cardiomyopathy "should theoretically be present in males and females equally," Dr. Iacopo Olivotto commented to Reuters Health, because it is a genetic disease with an inheritance pattern that requires only one parent to have the condition.

People with hypertrophic cardiomyopathy (HCM) suffer from progressive weakening of the heart, which becomes enlarged in an attempt to compensate.

Among nearly 1000 consecutive HCM patients seen at three institutions in Italy and the U.S. there was a 3-to-2 predominance of men vs. women, "consistent with most previous clinical reports showing a male majority," Olivotto from Azienda Ospedaliera Universitaria Careggi in Florence and colleagues note in the Journal of the American College of Cardiology.

Compared with men, women with HCM were significantly older on average at the first evaluation (47 vs. 38 years) and more symptomatic.

During an average of 6 years of follow up, female patients with HCM had a 50 percent greater risk of progression to severe heart failure or death from heart failure or stroke, compared with their male counterparts.

"Although other explanations may exist ... the main reason for this gender-related bias appears to be social," Olivotto told Reuters Health.

"Both in Italy and in the U.S., women with HCM are less likely to be identified in the course of routine screenings related to recreational or professional activities, and are only diagnosed when symptoms appear," the researcher explained.

"The message we would like to convey is that in genetic cardiac diseases, as for coronary artery disease, there is a need for enhanced awareness among women and their physicians," he stressed.

As he pointed out, an early diagnosis is particularly important in order to avert sudden cardiac death in patients with hypertrophic cardiomyopathy.

SOURCE: Journal of the American College of Cardiology, August 2, 2005.