Study suggests that outdated guidelines for diagnosing heart issues primarily in men are causing women to not receive important cardiac diagnoses

Women are missing out on crucial cardiac diagnoses due to outdated guidelines aimed at men, a study suggests.

According to research conducted by the British Heart Foundation, the current methods used to detect hypertrophic cardiomyopathy (HCM) do not take into consideration the natural differences between men and women, such as body size.

When allowances were made for the variations, rates of diagnosis increased by 20 per cent in women.

Experts suggest the ‘one size fits all approach’ must be updated to ensure women stop being overlooked for heart problems.

HCM is a genetic disorder that impacts one in every 500 individuals, causing the heart’s muscular wall to thicken, which in turn makes it more challenging for the heart to effectively pump blood throughout the body.

It can be life-threatening and can cause abnormal heart rhythms which can lead to cardiac arrest and sudden death.

While two-thirds of individuals diagnosed with HCM are men, researchers have noted that women are equally prone to the condition, indicating a gap in diagnosis rates between the two sexes.

Doctors typically use a variety of tests and scans, such as measuring the thickness of the wall of the left ventricle, the heart’s main pumping chamber.

Women are missing out on crucial cardiac diagnoses due to outdated guidelines aimed at men, a study suggests (stock image)

For the past 50 years, the threshold for diagnosing HCM has been 15mm for everyone. 

If the muscle is thicker than this, the patient is considered likely to have HCM.

But researchers found this to be inadequate as it does not account for natural differences in sex and body size.

They developed a new approach which was tested on 1,600 patients, already known to have the disease.

The team used an AI tool they developed to analyse MRI heart scans with greater precision and in much less time than a human can. 

It was given 5,000 MRI scans of healthy hearts and measured the thickness of the left ventricle wall in each.

From this, the researchers were able to determine what normal ventricle wall thickness 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 identification of HCM by 20 per cent, according to findings published in the Journal of the American College of Cardiology.

Further testing was carried out on data from more than 43,000 people on the UK Biobank.

Research by the British Heart Foundation found current techniques for checking for hypertrophic cardiomyopathy (HCM) fail to account for natural differences between the sexes, including body size (stock image)

When the new personalised thresholds were applied, the overall number of people identified with HCM was lower, suggesting fewer misdiagnoses.

There was also a more even split between men and women, with women making up 44 per cent 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 must be reconsidered.

‘Having the same cut-off 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-overdue update showing that a personalised approach improves the accuracy of diagnosis.

‘Effective treatments for HCM are starting to be used for the first time, making it more important than ever that we can correctly identify those who need them.’

When allowances were made for the variations, rates of diagnosis increased by 20 per cent in women (stock image)

Dr Sonya Babu-Narayan, of the British Heart Foundation and clinical cardiologist, said: ‘Hypertrophic cardiomyopathy is a severe, potentially life-threatening condition, and missed diagnosis means people that might benefit from new and effective treatments could slip through the net.’

At the same time, a diagnosis is itself a life-changing event and we should be making every effort to prevent misdiagnosing people.

‘By updating the traditional one-size-fits-all approach, this study redefines abnormal heart wall thickness, a key contributor to the diagnosis of hypertrophic cardiomyopathy.

‘As a result, more women and small individuals were identified who would otherwise be underdiagnosed.’