Quality of life and physical functioning in black and white adults with hypertrophic cardiomyopathy


      • Black adults are underrepresented in QOL/physical functioning research in HCM.
      • MLWHF scores were higher in the Black cohort but QOL categories were similar to the White cohort.
      • Comprehensive quality of life measures, including psychosocial stress, are needed.
      • NYHA class alone is inadequate to evaluate physical function in Black adults with HCM.



      Hypertrophic cardiomyopathy (HCM) is a common and clinically heterogeneous inherited cardiac disease. Quality of life (QOL) and physical functioning are important clinically but are underexplored in diverse populations with HCM.


      To examine predictors for and compare QOL and physical functioning in Black and White adults with HCM.


      We analyzed a sub-sample from a longitudinal prospective study on HCM. Eligibility criteria included self-identified Black and White adults (≥18 years) with clinical HCM. QOL was measured with the Minnesota Living with Heart Failure Questionnaire (MLWHF);physical functioning included age-adjusted exercise capacity and NYHA class. Covariates included HCM structural characteristics and common comorbidities. We analyzed data from 434 individuals, 57 (13.1%) of whom self-identified as Black/African American. Results: In this sample, the Black cohort had higher MLWHF scores, 31.2 (27.2) v. 23.9 (22.1), p=0.042, signifying worse QOL, but there were no intergroup differences when QOL was dichotomized. Mean metabolic equivalents (METs) on symptom-limited stress testing were similar, though the Black cohort was younger, 54.6 (13.4) v.62.5 (14.8) years, p=0.001. No one from the Black cohort achieved an “excellent-for-age” exercise capacity, and 64.1% had a “below-average-for-age” exercise capacity vs 47% in the White cohort, though this was not statistically significant, p=0.058. There was no difference between groups in advanced NYHA class. Female gender was associated with worse QOL and physical functioning irrespective of covariates.


      This study is a starting point that underscores the need for a more comprehensive examination of well-being and physical functioning in Black populations with HCM.



      BMI (Body Mass Index (kg/m2)), CAD (Coronary Artery Disease), HCM (Hypertrophic cardiomyopathy), HTN (Hypertension), LV (Left ventricular), LVH (Left ventricular hypertrophy), LVOTO (Left ventricular outflow tract obstruction), METs (Metabolic equivalents), MLWHF (Minnesota Living with Heart Failure), TIA (Transient Ischemic Attack)
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