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. 2018 May 3;13(5):e0196612.
doi: 10.1371/journal.pone.0196612. eCollection 2018.

Prevalence of clinically apparent hypertrophic cardiomyopathy in Germany-An analysis of over 5 million patients

Daniela Husser  1 , Laura Ueberham  1 , Josephine Jacob  2 , Denise Heuer  2 , Steffi Riedel-Heller  3 , Jochen Walker  2 , Gerhard Hindricks  1 , Andreas Bollmann  1
Affiliations

Prevalence of clinically apparent hypertrophic cardiomyopathy in Germany-An analysis of over 5 million patients

Daniela Husser et al. PLoS One. .

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease. Reported prevalence rates vary substantially between 1:500 (0.2%) and 1:3,000 (0.03%), which may be attributed to different study designs and population characteristics. Prevalence data for Germany is not available. Consequently, this study aimed (1) to quantify age- and gender-specific clinically diagnosed HCM prevalence in Germany based on the analysis of health care claims data of > 5 million insurants in 2015, and (2) to analyze temporal prevalence trends from 2011 to 2015.

Methods: Data were extracted from the InGef (Insitute for Applied Health Research) database, which is an anonymized healthcare claims database with longitudinal data from patients insured in one of approximately 70 German social health insurances (SHIs). Patients were classified as HCM prevalent, if they had at least one verified ambulatory or one hospital main- or secondary discharge diagnosis of HCM (I42.1 or I42.2).

Results: In 2015, HCM was prevalent in 4,000 out of 5,490,810 patients (0.07%; 1:1,372). HCM prevalence increased gradually with age from 7.4/100,000 persons (95% CI 5.2-10.1) in 0-9 years old to 298.7/100,000 persons (95% CI 276.4-322.4) in patients > 80 years. In all age categories, men had a numerically higher prevalence than women with significant differences in patients > 30 years. There was a gradual annual prevalence increase from 75.8 (95% CI 75.2-76.4) in 2011 to 84.2 (95% CI 83.5-84.8) in 2015 per 100,000 persons.

Conclusions: Overall, prevalence of clinically diagnosed HCM in Germany is lower than in systematic population studies based on echocardiographic diagnosis. Prevalence increased with advancing age and showed a constant yearly rise. Those observations may improve our understanding of the burden of this genetic heart disease on the health care system in Germany, increase the diagnostic awareness among clinicians and shape future screening and management strategies.

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Conflict of interest statement

Competing Interests: This study was supported by the Volkswagen Foundation Germany through the Lichtenberg professorship program to DH (# 84901). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Gender-stratified age distribution of the HCM cohort.
Fig 2
Fig 2. Temporal trends of HCM prevalence.
See this image and copyright information in PMC

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Grants and funding

This study was supported by the Volkswagen Foundation Germany through the Lichtenberg professorship program to DH (# 84901). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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