Abstract FR486: Trends of Hypertension and HOCM outcomes heart failure, mortality, and arrhythmias compared to HOCM without Hypertension

Introduction: Patients with hypertrophic obstructive cardiomyopathy (HOCM) have coexistent hypertension (HTN). However, HTN impact on cardiovascular outcomes in patients with HOCM is not well documented. Hypothesis: We compared the cardiovascular outcomes of HTN in patients with HOCM. Methods: This retrospective cohort study, using TriNetX Global Collaborative Study, analysed patients aged ≥18 years from 1/1/2007 to 5/25/2025. After 1:1 propensity score matching, two cohorts, 11,684 patients each, were formed: cohort 1 (HOCM + HTN) and cohort 2 (HOCM without HTN). The study population's mean age was 58 years (51% male, 48% female, 1% unknown gender). The median follow-up period was 949 days (IQR: 1,930) Cohort 1; 592 days (IQR: 1,627.5) Cohort 2. Primary and secondary outcomes evaluated were all-cause mortality, HF, atrial fibrillation/flutter (AF), ventricular tachycardia (VT), and ventricular fibrillation (VF). We calculated risk ratio (RR), hazard ratio (HR), 95% confidence interval (CI) and p-value using TrinetX platform. Results: The mortality rate in cohort 1 was 11.56%, compared to 9.37% in cohort 2 (RR 1.234, 95% CI: 1.144–1.33, p < 0.0001). However, the HR for death was 1.024 (95% CI: 0.945–1.109, p < 0.0001), with a non-significant log-rank test (p = 0.5611). Cohort 1 had significantly higher rates of HF (RR 1.543, 95% CI: 1.479–1.611, HR 1.444, 95% CI: 1.374–1.518, p < 0.0001) and AF (RR 1.454, 95% CI: 1.391–1.52, HR 1.338, 95% CI: 1.271–1.408, p < 0.0001) compared to cohort 2. VT was also more common in Cohort 1 (14.25% vs. 11.54%, RR 1.235, 95% CI: 1.155–1.321, p < 0.0001), although the HR (1.053, 95% CI: 0.98–1.132) was not statistically significant (p = 0.6523). The incidence of VF was higher in cohort 1 compared to cohort 2 (2.14% vs. 1.75%, RR 1.225, 95% CI: 1.02–1.472, p = 0.0292), with a non-significant HR of 1.036 (95% CI: 0.861–1.247, p = 0.6168). Conclusion: HTN with HOCM is associated with significantly increased adverse outcomes, including HF and AF. While comorbid HTN showed higher risks for mortality, VT, and VF in crude analysis, survival analysis showed non-significant results.