A U.S. study shows patients with hypertrophic cardiomyopathy (HCM) who live in low-income neighborhoods or have worse social determinants of health (SDOH) scores are more likely to have adverse clinical outcomes. These data were reported by Neha Hafeez, MD, of the University of Pennsylvania, and colleagues, in a manuscript published online Wednesday in JAMA Cardiology. Several individual- and community-level factors are encompassed when measuring SDOH, including income, education, housing and more. People with worse SDOH have a more difficult time accessing good health care. All these factors influence health outcomes. SDOH and living situations influence one’s risk of heart disease. When SDOH are poor, people are at greater risk of obesity, hypertension and diabetes. Few data are available on the relationship between cardiovascular diseases with strong genetic components, such as HCM, and SDOH. Investigators in this multicenter, prospective cohort study utilized data from the Sarcomeric Human Cardiomyopathy Registry, which contains patients with HCM, and followed patients for a median time of 2.15 years. Data were analyzed between March 2024 and June 2025. Addresses were categorized by zip code, and median household incomes were determined by the zip code locations. The social deprivation index (SDI) was used to indicate more deprived locations (0-100, high scores=more deprived). Adjustments were made for age, body mass index (BMI), high blood pressure and sex, to determine the independent associations between median household income and SDI with heart failure (HF), ventricular arrhythmias (VA) and a composite outcome of HF, VA, atrial fibrillation, stroke and death. A total of 4,431 U.S. patients with HCM (median age at diagnosis=51.3 years, 42.0% female, median area-based household income=$80,000, median SDI=25) were included in the study. HF had an adjusted hazard ratio (aHR) of 2.07 (95% confidence interval [CI]=1.77-2.42, p<0.001), VA had an aHR of 1.31 (95% CI=0.97-1.78, p=0.08) and the composite outcome had an aHR of 1.52 (95% CI=1.36-1.69, p<0.001). When the lowest SDI and highest SDI were compared for aHR, the aHR for HF was 1.48 (95% CI=1.29-1.70; p<0.001), 1.55 for VA (95% CI=1.15-2.09; p=0.004) and 1.36 for the composite outcome (95% CI=1.22-1.50; p<0.001). Overall, lower household incomes and worse SDI scores in patients with HCM are associated with worse clinical outcomes. “Future studies are needed to identify solutions to reduce risk and improve access and care for patients with HCM who experience more adverse SDOH to improve the overall disease trajectory in these patients,” the investigators concluded. Source: Hafeez N, Claggett BL, Owens AT, et al. Social determinants of health and clinical outcomes in hypertrophic cardiomyopathy. JAMA Cardiol. 2026 January 7 (Article in Press). Image Credit: PHalexaviles – stock.adobe.com