Heart ailment seems under-recognized in women

By Megan Rauscher

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.