Abstract P2068: Prevalence of blood pressure control among adults with hypertrophic cardiomyopathy and hypertension

Abstract

Introduction: Hypertension (HTN) occurs in ~50% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac disorder. Most individuals with HCM (~70%) have left ventricular outflow tract obstruction, precluding use of first- or second line anti-hypertensive agents. Little is known about the prevalence of blood pressure (BP) control among adults with HCM and HTN. Objectives: We sought to describe the prevalence of BP control among adults with HCM and HTN in a large clinical cohort. Methods: Data for this cross-sectional analysis was extracted from electronic health records of adults diagnosed with HCM (ICD codes I42.1/I42.2) who are treated for HTN and receive care in a large health system in New York. We conducted Wilcoxon-rank sum and Pearson chi-squared tests to compare demographic and clinical characteristics, and receipt of HCM specialty care (vs. not) between adults with and without controlled BP. Uncontrolled BP was defined as use of antihypertensive agents and systolic BP≥140 mmHg or diastolic BP ≥ 90mmHg. Results: Of 4,054 adults with HCM, 2,401 (59%) had HTN, 44% women, 69% Non-Hispanic (NH) white, 13% NH Black, 6.3% Hispanic/Latine. Adults with HCM and HTN were older, mean ± standard deviation, 69±15 vs 63±20 years, had higher body mass index (BMI), 28±7 vs 27±8, p<0.001, and higher systolic and diastolic BP, 131/76 ±19/12 vs 128/75±20/11 mmHg, compared to those with HCM only. A higher proportion of adults with HCM and HTN were seen in a specialized HCM program, 50% vs 38%, p<0.001, compared to adults with HCM only. Among adults with HCM and HTN, 824 (34%) had uncontrolled BP. Participants with uncontrolled BP were more likely to be older, 70±14 vs 68±16 years, p<0.001, have a higher BMI, 29±9 vs 28±8, p>0.001, and have co-morbid diabetes, 11% vs 8%, p<0.001, compared to participants with controlled BP. BP control did not significantly differ between women and men. There was a higher proportion of NH Black and Hispanic/Latine participants among those with uncontrolled BP, compared to participants with controlled BP, 16% vs 11%, and 7.4% vs 5.7%, respectively, p<0.001. Forty-seven % of participants with uncontrolled BP received HCM specialty care vs 51% of those with controlled BP, but the difference was not statistically significant. Conclusions: Over a third of adults with HCM and HTN had uncontrolled BP in this cohort. Findings highlight the need for focused strategies to improve BP control among this population.