Study of older people with hypertrophic cardiomyopathy

27th August 2015

Older people with hypertrophic cardiomyopathy (HCM) are more likely to die from unrelated diseases than HCM, says a new study.

Death due to HCM-related problems in those aged 60 or over are less than for other ages, and the estimated annual risk of death is less than that in the general population, says the report on the American College of Cardiology website.

Non-HCM-related disorders are more likely to affect how long HCM patients live in their seventh decade and beyond than HCM specifically.

Older HCM patients (beyond mid-life) are being increasingly recognised due to more awareness of the disease and more cases being picked up from improved cardiac imaging.

In rare cases, HCM can cause death in middle-aged and young patients. However, it is now evident that many (if not most) affected patients probably experience a relatively benign clinical course and even normal (if not extended) life expectancy, said the report authored by Dr Ankur Kalra, from the Beth Israel Deaconess Medical Centre at Harvard Medical School, and Dr Barry J Maron.

Death due to HCM related heart problems in patients aged 60 or over are less than rates reported at other ages, and the estimated annual mortality risk is less than that in the general population.

Non-HCM-related disorders are more likely to affect how long HCM patients live in their seventh decade and beyond than HCM specifically.

In this age group almost 80% of patients report no or mild HCM-related heart failure symptoms

In a study of 428 consecutive HCM patients between the ages of 60 to 91 years at the start of the study, survival at five and 10 years (accounting for all-cause mortality) was 77% and 54%, respectively, with 125 patients living to 80 years or more.

The doctors concluded that recommendations for internal defibrillators in older HCM patients thought to be at risk of dying suddenly should be made on a case-by-case basis with prudent restraint.

References:

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Maron BJ, Rowin EJ, Casey SA, et al. Risk stratification and outcome of patients with hypertrophic cardiomyopathy >=60 years of age. Circulation 2013;127:585-93.

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