The frequency and functional impact of hypertension overlapping on hypertrophic cardiomyopathy: comparison between older and younger patients

Abstract

Background and aim: In a previous report, when hypertension (HT) overlapped on hypertrophic cardiomyopathy (HTHCM), the decreased survival rate was associated with higher NYHA classes. The study concerned only elderly patients and therefore we decided to extend it by: (1) assessment of the frequency and age-distribution of HTHCM in HCM population; and (2) the comparison of NYHA class between HTHCM and HCM both in younger and older patients.

Patients and methods: We retrospectively viewed 123 HCM patients with regard to the presence of hypertension as a concomitant disease. The HTHCM and HCM patients were compared with regard to NYHA functional classes within younger (<50years of age) and older (>50 years of age) subgroups.

Results: Of the 123 HCM patients, 24 (19.5%) had associated hypertension. Among younger patients, 15.7% had concomitant hypertension, while in older patients the percentage of HTHCM significantly increased to 38%. In younger patients, the mean values of the NYHA class were significantly higher in HTHCM in comparison to HCM patients (2.19 ± 0.37 vs 1.94 ± 0.56, P < 0.05), whereas in the older patients, the mean values of NYHA class were comparable between HTHCM and HCM patients (2.13 ± 0.33 vs 2.23 ± 0.42, P > 0.05).

Conclusion: Hypertension associated with HCM is not rare in young patients, and this coincidence significantly increases in older patients. Hypertension overlapping on HCM additionally deteriorates functional status in younger patients whereas in the older patients NYHA class the difference between HTHCM and HCM narrows and becomes insignificant.