Jun-Bean Park1,2, Da Hye Kim3, Heesun Lee1,4, In-Chang Hwang1,5, Yeonyee E Yoon1,5, Hyo Eun Park1,4, Su-Yeon Choi1,4, Yong-Jin Kim1,2, Goo-Yeong Cho1,5, Kyungdo Han3, Steve R Ommen6, Hyung-Kwan Kim1,2. 1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. 3. Department of Medical Statistics, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea. 4. Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea. 5. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea. 6. Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
Abstract
AIMS: We sought to investigate the association of obesity and metabolic health status with the incidence of clinical hypertrophic cardiomyopathy (HCM) diagnosis in the general population. Our goal was to identify modifiable risk factors to attenuate clinical expression of HCM, enabling management evolution from a mostly passive strategy of risk stratification to a proactive strategy of modifying disease expression. METHODS: Using nationwide population-based data from the Korean National Health Insurance Service, 28,679,891 people who were free of prevalent HCM and who underwent health examinations between 2009 and 2015 were followed until 31 December 2016. The primary outcome was clinical HCM that was defined as incident diagnosis of HCM during the follow-up, after a blanking period of 12 months. RESULTS: Over a median follow-up of 5.2 years, 0.027% (n = 7851) of the study participants were diagnosed as incident HCM. The incidence rate per 1000 person-years was 0.059. A significant association was found between body mass index (BMI) and the incidence of clinical HCM after multivariate adjustment, with a hazard ratio per 1 kg/m2 increase in BMI of 1.063 (95% confidence interval 1.051-1.075). Metabolically unhealthy participants had a greater incidence of HCM than metabolically healthy participants, regardless of obesity status. The effect of BMI was more pronounced in several subgroups, including participants with no hypertension, those aged less than 65 years and men. CONCLUSION: We found that individuals with obesity and/or metabolic abnormalities had a significantly higher incidence of clinical HCM diagnosis than their counterparts. Efforts to manage obesity and metabolic abnormalities may be important in modifying clinical expression of HCM.
AIMS: We sought to investigate the association of obesity and metabolic health status with the incidence of clinical hypertrophic cardiomyopathy (HCM) diagnosis in the general population. Our goal was to identify modifiable risk factors to attenuate clinical expression of HCM, enabling management evolution from a mostly passive strategy of risk stratification to a proactive strategy of modifying disease expression. METHODS: Using nationwide population-based data from the Korean National Health Insurance Service, 28,679,891 people who were free of prevalent HCM and who underwent health examinations between 2009 and 2015 were followed until 31 December 2016. The primary outcome was clinical HCM that was defined as incident diagnosis of HCM during the follow-up, after a blanking period of 12 months. RESULTS: Over a median follow-up of 5.2 years, 0.027% (n = 7851) of the study participants were diagnosed as incident HCM. The incidence rate per 1000 person-years was 0.059. A significant association was found between body mass index (BMI) and the incidence of clinical HCM after multivariate adjustment, with a hazard ratio per 1 kg/m2 increase in BMI of 1.063 (95% confidence interval 1.051-1.075). Metabolically unhealthy participants had a greater incidence of HCM than metabolically healthy participants, regardless of obesity status. The effect of BMI was more pronounced in several subgroups, including participants with no hypertension, those aged less than 65 years and men. CONCLUSION: We found that individuals with obesity and/or metabolic abnormalities had a significantly higher incidence of clinical HCM diagnosis than their counterparts. Efforts to manage obesity and metabolic abnormalities may be important in modifying clinical expression of HCM.
Entities:
Keywords:
Obesity; hypertrophic cardiomyopathy; metabolic health status
Authors: Edgar E Nollet; B Daan Westenbrink; Rudolf A de Boer; Diederik W D Kuster; Jolanda van der Velden Journal: J Am Heart Assoc Date: 2020-11-11 Impact factor: 6.106