Study finds a better way to detect heart disease in women

Time of India

27-04-2025

Although heart diseases might widely be known as 'man's disease', recent research has revealed that heart-related diseases are the leading cause of death in women.
While men may be at higher risk for heart disease and heart attacks at a younger age, heart disease is a significant health concern for both men and women. Moreover, while women are as likely to have a heart attack as men, they are more likely to die from one.
In fact, cardiovascular disease (CVD), including heart attacks, globally, is responsible for 35% of all female deaths.
Although the
recent research
might trigger a sense of panic, the better news is – a new study has emerged to show that using personalized heart wall measurements leads to more accurate hypertrophic cardiomyopathy diagnoses, especially in women.
What does the study say?
People with hidden heart conditions may be at risk because current medical guidelines overlook important personal differences. This new study, recently published in the
Journal of the American College of Cardiology
, is questioning an outdated standard for diagnosing heart disease that often goes unnoticed until it is too late.
Hypertrophic cardiomyopathy (HCM) affects about one in every 500 people. It can lead to dangerous heart rhythms, sudden cardiac arrest, and even death. This genetic condition thickens the heart muscle, making it harder for the heart to pump blood. For years, doctors diagnosed HCM based on one measurement: if the left ventricle wall is 15 millimeters thick or more, it is considered abnormal.
While this method has saved lives, scientists are now highlighting its flaws. A recent study shows that this fixed threshold may leave many people undiagnosed, particularly women and smaller individuals.
How current guidelines leave gaps:
HCM is usually diagnosed by measuring the thickness of the wall in the heart's main pumping chamber. For 50 years, the guideline has remained the same: a wall thicker than 15 millimeters may indicate HCM. This cutoff does not change based on age, sex, or body size, which is a problem. Not all hearts are the same size. Women typically have smaller hearts, so a thickened wall in a smaller heart might not reach the 15-millimeter mark, even if the person has HCM. Men, who generally have larger hearts, might meet the threshold even if they do not have the disease.
Data supports this concern. Currently, two out of three people diagnosed with HCM are men. However, researchers believe that men and women are equally likely to have the disease, and women may be overlooked by an outdated system.
Dr. Hunain Shiwani, who led the study at the UCL Institute of Cardiovascular Science, said, 'This threshold, based on studies from the 1970s, needs to be reconsidered. Using the same cutoff for everyone, regardless of age, sex, or size, ignores how these factors strongly influence heart wall thickness.'
Personalized method to ensure better accuracy:
To address this issue, researchers developed a smarter, more individual approach. They used artificial intelligence to study over 5,000 MRI heart scans from healthy individuals. The AI measured heart wall thickness in people of different ages, sexes, and body sizes. From this, they created a range of normal values that reflect actual differences in heart structure.
Instead of a single number, the new method adjusts the threshold based on a person's profile. For example, older or larger people might have a higher cutoff, while younger, smaller people, including many women, would have a lower one.
When researchers tested this updated method on 1,600 patients already diagnosed with HCM, they saw significant improvements. Among women, detection rates increased by 20 percentage points. This means that one in five women who would have been missed before are now recognized as having the disease.
Dr. Shiwani added, 'Our research provides a much-needed update, showing that a personalized approach improves diagnosis accuracy. Effective treatments for HCM are starting to be used for the first time, making it crucial to correctly identify those who need them.'
The new guidelines:
Researchers applied new and old methods to check for hypertrophic cardiomyopathy (HCM) in over 43,000 people from a health database. Using the old method, only one in eight people flagged as possibly having HCM was a woman. The flagged individuals were usually older, taller, and heavier than average.
With the new personalized approach, the number of flagged cases actually decreased, which means fewer false positives. Importantly, nearly half of those identified (44%) were women, which aligns better with the fact that HCM affects both men and women equally.
The goal is not only to find more cases but also to avoid mistakes. A wrong diagnosis can change someone's life by leading to unnecessary tests, anxiety, or medication. Dr. Sonya Babu-Narayan from the British Heart Foundation highlighted the importance of preventing misdiagnoses. She said, 'A diagnosis changes lives, so we should work hard to avoid misdiagnosing people.'
By updating the old approach, this study redefines what is considered abnormal heart wall thickness, a key factor in diagnosing HCM. This change helps identify more women and smaller individuals who might otherwise be overlooked.
The way forward:
The research findings are available online in the Journal of the American College of Cardiology. This research could greatly change how doctors identify and treat HCM worldwide. The scientists want to ensure that the new guidelines also work with echocardiograms, as these are more commonly used in clinics than MRIs. They are also exploring ways to include other important factors, such as race and ethnicity, in future diagnostic tools. The aim is to help doctors make better decisions for every patient, regardless of their shape or size.
The research team hopes that heart specialists in Europe and North America will adopt these updated guidelines soon. Personalized thresholds could become standard, leading to fairer and more accurate diagnoses.
Dr. Babu-Narayan concluded, 'This more personalized approach to defining abnormal heart muscle thickness marks a new era for accurate diagnosis for patients and families affected by hypertrophic cardiomyopathy.'
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