Association Between Baseline Hypertension and Longitudinal Functional Status in Obstructive Hypertrophic Cardiomyopathy Treated With Mavacamten

Hypertension is common in hypertrophic cardiomyopathy (HCM) yet its impact on patients on long-term mavacamten is unknown. In this single-center observational study of 163 patients with symptomatic obstructive HCM treated with mavacamten for up to 108 weeks, hemodynamic and functional responses stratified by baseline hypertension status (60.7% hypertensive) were compared. Mavacamten produced similar reductions in resting and Valsalva LVOT gradients regardless of hypertension status. However, patients with hypertension had a significantly lower probability of achieving NYHA Class I functional status over time (interaction p=0.01). These findings suggest that hypertension-related factors beyond LVOT obstruction may limit complete functional recovery in obstructive HCM despite effective gradient reduction with mavacamten.