Abstract 14837: Patients with Hypertrophic Cardiomyopathy are Less Physically Active than the General Population

Abstract

Guidelines for participation in competitive athletics for hypertrophic cardiomyopathy (HCM) patients are stringent due to risk for sudden cardiac death. Restrictions are also imposed for recreational exercise due to uncertainty about safety and lack of data to inform risk. We hypothesize that HCM patients are less active compared to the general population, and that imposed exercise restrictions negatively impact health.

Methods: A voluntary survey, drawing questions from the 2007-2008 National Health and Nutrition Examination Survey (NHANES), was posted on the HCM Association (HCMA) website and administered to HCM patients at the University of Michigan. Data from HCM patients (age ≥ 12, n = 897) were compared to published data from NHANES participants (age ≥ 12, n = 2,858) using Chi² analysis or student t-tests with multivariate regression analysis. Propensity score matching on age and gender was employed to assure appropriate comparisons and analysis was limited to non-Hispanic whites as this racial/ethnic group represented >95% of the HCM cohort.

Results: Compared to NHANES, fewer HCM patients have jobs demanding vigorous or moderate work (odd ratios 0.31 and 0.48 respectively, P<0.0001). Of those who exercise recreationally, HCM patients spend less time participating in vigorous (2.2 ± 2.8 vs 3.8 ± 2.8 hrs/wk, P<0.01) or moderate activity (2.1 ± 2.7 vs 3.2 ± 2.6 hrs/wk, P0.0001). Notably, body mass index (BMI) was higher in the HCM cohort compared to NHANES (29.7 ± 6.3 vs. 28.3 ± 6.7, P<0.001). Sixty-four percent of HCM patients cut back on their activity after diagnosis and 61% report that exercise restrictions impact their emotional well-being.

Conclusions/Discussion: HCM patients are less active than the general US population, have lower self-reported exercise capacity, higher BMIs, and suffer emotional consequences from exercise restrictions. The well-established relationship between inactivity, obesity and cardiovascular mortality may be exaggerated in HCM patients. More data are needed on exercise in HCM to strike a reasonable balance between its acute risks and long term health benefits.