Women With Obstructive Hypertrophic Cardiomyopathy Are Less Likely to Receive Treatment

Among patients with obstructive hypertrophic cardiomyopathy (oHCM), women are less likely to be prescribed beta blockers and angiotensin-converting enzyme (ACE) inhibitors or have an implantable cardioverter-defibrillator compared with men. These findings were published in BMJ Open.

A retrospective observational study used data from the MarketScan Commercial Claims and Encounters Database from IBM Watson Health to identify patients with more than 1 claim with an International Statistical Classification of Diseases, Tenth Revision (ICD-10), clinical modification diagnosis code of oHCM from 2016 to 2018. The researchers sought to evaluate sex differences in demographic and clinical characteristics, treatments, and outcomes for patients with oHCM.

A total of 9306 patients with oHCM were included (60.5% men, P <.001). Women had a mean age of 50±15 years compared with 49±15 years for men (P <.001).

Women more frequently had hypertension (44.4% vs 41.7%, P =.012), diabetes (15.6% vs 13.5%, P =.005), and stroke (1.9% vs 1.3%, P =.038) but were less likely to have dyslipidemia (18.7% vs 22.3%, P <.001) and coronary artery disease (9.2% vs 11.2%, P =.002), compared with men.

Women were also less likely to be prescribed beta blockers (42.7% vs 45.2%, P =.017), ACE inhibitors (9.9% vs 12.3%, P =.001), and anticoagulants (6.9% vs 8.9%, P =.001) or have an implantable cardioverter-defibrillator (1.7% vs 2.6%, P =.005), compared with men.

The rates of alcohol septal ablation (ASA) and myectomy were not statistically significant between women and men, respectively (ASA, 0.08% vs 0.05%, P =.600; SM, 0.35% vs 0.18%, P =.096).

Women were less likely to be diagnosed with atrial fibrillation (6.7% vs 9.9%, P <.001) and ventricular tachycardia or fibrillation (6.1% vs 8.1%, P =.001), compared with men.

Among several study limitations, MarketScan only includes individuals with private insurance. Also, the analysis did not account for continuing enrollment of patients, and some patients may have disenrolled during the study period. The investigators were also unable to obtain specific clinical data and distinguish among diagnostic characteristics.

“The results of this analysis may aid providers in the treatment of women with oHCM, and future studies using large, clinical real-world evidence are warranted to understand the root cause of these potential treatment disparities in women with oHCM,” the study authors wrote.

Reference

Butzner M, Leslie D, Cuffee Y, Hollenbeak CS, Sciamanna C, Abraham TP. Sex differences in clinical outcomes for obstructive hypertrophic cardiomyopathy in the USA: a retrospective observational study of administrative claims data. BMJ Open. Published online March 9, 2022. doi:10.1136/ bmjopen-2021-058151