Women are missing out on crucial cardiac diagnoses due to outdated guidelines aimed at men, a study suggests.
Research by the British Heart Foundation found that current techniques for detecting hypertrophic cardiomyopathy (HCM) do not take into account natural differences between the sexes, including body size.
When variations were taken into account, diagnosis rates increased by 20 percent in women.
Experts suggest the “one-size-fits-all approach” needs to be updated to ensure women are no longer ignored for heart problems.
HCM, a genetic condition that affects one in 500 people, causes the heart’s muscular wall to thicken, making it difficult for the heart to pump blood around the body.
It can be life-threatening and cause abnormal heart rhythms that can lead to cardiac arrest and sudden death.
Two-thirds of people diagnosed with the condition are men, but researchers said women are just as likely to have the condition, pointing to a gap in diagnosis.
Doctors often use a variety of tests and scans, such as measuring the thickness of the wall of the left ventricle, the main pumping chamber of the heart.
Women are missing out on crucial heart diagnoses due to outdated guidelines aimed at men, study suggests (file image)
For the past 50 years, the threshold for diagnosing HCM has been 15 mm for everyone.
If the muscle is thicker than this, the patient is considered likely to have HCM.
But the researchers found this to be inadequate as it does not take into account natural differences in sex and body size.
They developed a new approach that was tested on 1,600 patients already known to have the disease.
The team used an artificial intelligence tool they developed to analyze cardiac MRI scans more accurately and in much less time than a human.
5,000 MRIs of healthy hearts were performed and the thickness of the left ventricular wall was measured in each one.
From this, the researchers were able to determine what the normal thickness of the ventricle wall is for people of different ages, sexes and sizes, measured by body surface area.
Researchers found that the new method was particularly beneficial for women, increasing HCM identification by 20 percent, according to findings published in the Journal of the American College of Cardiology.
Further testing was carried out using data from more than 43,000 people from the UK Biobank.
Research by the British Heart Foundation found that current techniques for detecting hypertrophic cardiomyopathy (HCM) do not take into account natural differences between the sexes, including body size (file image)
When the new personalized thresholds were applied, the total number of people identified with HCM was lower, suggesting fewer misdiagnoses.
There was also a more equal split between men and women, with women making up 44 percent of those identified, reflecting the belief that women have been missing out on diagnosis.
Lead author Dr Hunain Shiwani, of University College London and St Bartholomew’s Hospital, said the current threshold is based on studies from the 1970s and needs to be reconsidered.
“Having the same limit for everyone, regardless of age, sex or size, completely ignores the fact that heart wall thickness is strongly influenced by these factors,” he said.
“Our research provides a long-awaited update showing that a personalized approach improves diagnostic accuracy.
“Effective treatments for HCM are beginning to be used for the first time, so it is more important than ever that we can correctly identify those who need them.”
When variations were taken into account, diagnosis rates increased by 20 percent in women (file image)
Dr Sonya Babu-Narayan, from the British Heart Foundation and clinical cardiologist, said: “Hypertrophic cardiomyopathy is a serious and life-threatening condition, and a missed diagnosis means that people who could benefit from new, effective treatments could escape of the network”.
At the same time, a diagnosis is itself a life-changing event and we should do everything we can to avoid misdiagnosing people.
‘By updating the traditional one-size-fits-all approach, this study redefines abnormal heart wall thickness, a key factor in the diagnosis of hypertrophic cardiomyopathy.
“As a result, more women and small people who would otherwise be underdiagnosed were identified.”