Key result
Overall lifetime risk of cardiomyopathy reaches ~2.5% in Sweden, led primarily by dilated cardiomyopathy.
Why the study?
Robust population-based estimates of the lifetime risk of cardiomyopathies are lacking, temporal trends in incidence remain uncertain, and contemporary data on premature mortality and life expectancy after diagnosis are limited.
Cohort (n=13,600,000)
Yes
This nationwide Swedish cohort study establishes that the lifetime risk of cardiomyopathy in the general population is 2.5% (half of which is dilated cardiomyopathy), associated with an average loss of 8.7 life-years and an 80% increase in the age-adjusted incidence of hypertrophic cardiomyopathy over time.
Highlights cardiomyopathy burden for risk discussions; extends prior estimates with nationwide life-years lost and rising HCM incidence.
Background Cardiomyopathies are a heterogeneous group of myocardial disorders associated with heart failure, arrhythmias, heart transplantation, and sudden cardiac death, often affecting individuals without traditional cardiovascular risk factors. Although recent advances in imaging, genetics, and registry data suggest that cardiomyopathies may be more common than previously recognised, robust population-based estimates of lifetime risk are lacking. In addition, temporal trends in incidence remain uncertain, and contemporary data on premature mortality and life expectancy following diagnosis are limited. Purpose To estimate the lifetime risk and life-years lost due to cardiomyopathies in the Swedish population and assess temporal trends in incidence. Methods We conducted a nationwide, registry-based cohort study including all individuals born in 1922 and later, residing in Sweden between 2003 and 2023. Cardiomyopathy diagnoses were identified from nationwide registers using validated algorithms. Lifetime risk was estimated using competing risk models while incidence trends were assessed from age-standardised rates and joinpoint regression. Results Among 13.6 million individuals, 58,735 received a cardiomyopathy diagnosis. The lifetime risk was 2.50% (95%CI=2.48-2.52) overall, and 50% higher in men. Lifetime risk was 1.21% (95%CI=1.20-1.22) for dilated cardiomyopathy (DCM), 0.62% (95%CI=0.61-0.63) for hypertrophic cardiomyopathy (HCM), and 0.03% (95%CI=0.03-0.03) for restrictive cardiomyopathy (RCM). On average, 8.7 life-years were lost to cardiomyopathy, highest for RCM (12.2 years), 9.5 years for DCM, and lowest for HCM (6.8 years). The age-adjusted incidence of HCM increased 80% over time, while DCM and RCM remained stable. Rising incidence was most pronounced in older age groups. Conclusions In this nationwide study, the lifetime risk of cardiomyopathy was 2.5% in adults, half of which represented DCM, and markedly higher in men. Life-years lost were highest for RCM and lowest for HCM. Temporal trends suggest a rising burden of HCM. These findings highlight the need for targeted prevention, early detection strategies, and further research into underlying drivers.
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Linner et al. (2026) conducted a cohort in Cardiomyopathy (including dilated, hypertrophic, and restrictive cardiomyopathy) (n=13,600,000). General population exposure / Cardiomyopathy subtypes (DCM, HCM, RCM) was evaluated on Lifetime risk of cardiomyopathy (2.50%, 95% CI 2.48-2.52). Cardiomyopathy had an overall lifetime risk of 2.50% (95% CI 2.48-2.52) in the Swedish population, with 1.21% for dilated and 0.62% for hypertrophic cardiomyopathy, causing 8.7 life-years lost.
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