Morbidity from Congestive and Hypertrophic Cardiomyopathy in the Minneapolis-St. Paul Metropolitan Area: 1979-1984

Steven S Coughlin, PhD, Division of Medical Oncology, Vincent T. Lombardi Cancer Research Center, Georgetown niversity Medical Center, 3800 Reservoir Road NW, Washington, DC 20007-2197 (USA) Dear Sir, The recent article by Lilienfeld et al. [ 1 ] provides additional information about trends in morbidity from dilated and hypertrophic cardiomyopathy in a predominantly Caucasian population, including sex-specific differences in hospital discharge rates. However, the authors’ statement that gender was not found to be a risk factor for dilated cardiomyopathy in a case-control study carried out in Baltimore, Md. [2], is somewhat misleading, as the cases and controls were matched on sex and age categories. We were unable to obtain estimates of the relative odds for male gender because sex was controlled for in the design of the study. Nonetheless, 60% (57 of 95) of the cases in our series were males [2]. My colleagues and I have also observed male/female ratios greater than one in more recent epide-miologic studies of idiopathic dilated cardiomyopathy conducted in Washington, D.C. [3], and Washington County, Md. [unpubl. data]. The apparent male predominance in idiopathic dilated cardiomyopathy may be due to biologic factors, such as hormonal influences, or to differences in environmental factors, such as cigarette smoking, alcohol consumption or occupational exposures. Gender-related differences in the use of health services or access to diagnostic procedures may also explain this finding. References Lilienfeld DE, Sprafka JM, Pham DL, Baxter J: Morbidity from congestive and hypertrophic cardiomyopathy in the Minneapolis-St. Paul Metropolitan Area: 1979– 1984. Cardiology 1992;81:71-76. Coughlin SS, Szklo M, Baughman K, Pearson TA: The epidemiology of idiopathic dilated cardiomyopathy in a biracial community. Am J Epidemiol 1990;131:48-56. Coughlin SS: Toward the primary prevention of idiopathic dilated cardiomyopathy (editorial). J Natl Med Assoc 1991;83:949:950.