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Published on: August 8, 2022
Sex Differences in Hypertrophic Cardiomyopathy
Sonu Abraham1, Natalie Tapaskar2, Anu Saji3
1Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA.
Insights
Women with hypertrophic cardiomyopathy (HCM) face later diagnoses and more severe symptoms than men. Recognizing sex-specific differences is crucial for improving care and outcomes for women with HCM.
Area of Science:
- Cardiology
- Sex-based Medicine
- Cardiovascular Research
Background:
- Hypertrophic cardiomyopathy (HCM) affects males and females differently.
- Understanding these sex-based disparities is critical for effective management.
Purpose of the Study:
- To review current evidence on sex-based differences in hypertrophic cardiomyopathy.
- To highlight disparities in presentation, progression, outcomes, and management.
Main Methods:
- Systematic review of contemporary scientific literature.
- Analysis of studies reporting sex-specific data in HCM.
Main Results:
- Women with HCM are diagnosed later, present with more severe symptoms, and have greater heart failure burden.
- Despite similar risks for arrhythmias, women experience worse quality of life and faster progression to advanced heart failure.
- Current risk assessment tools may underestimate disease severity in women; cardiac myosin inhibitors show promise.
Conclusions:
- Sex-specific differences significantly influence HCM phenotype, progression, and management.
- Addressing disparities in care access and clinical trial representation is essential.
- Individualized care recognizing sex differences is key to improving outcomes for women with HCM.
Purpose Of Review:
This review summarizes contemporary evidence regarding sex-based differences in hypertrophic cardiomyopathy (HCM), including disparities in presentation, disease progression, outcomes, and management.
Recent Findings:
Women with HCM are frequently diagnosed later than men and often present with more advanced symptoms, greater left ventricular outflow tract obstruction, worse diastolic dysfunction, and higher heart failure burden. Despite similar rates of ventricular arrhythmias and sudden cardiac death, women experience greater progression to advanced heart failure and poorer quality of life. Emerging evidence suggests that current sex-neutral risk assessment tools may underestimate disease severity in women. Cardiac myosin inhibitors demonstrate similar efficacy across sexes, with some studies suggesting greater symptomatic improvement in women. Persistent disparities in referral patterns, access to specialized care, and representation in clinical trials continue to affect outcomes. Sex-specific differences significantly impact the phenotype, progression, and management of HCM. Greater recognition of these differences is essential to improve individualized care and reduce disparities in outcomes for women with HCM.
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