Anaesthetic drugs & techniques
Epidemiology of malignant hyperthermia in the UK from 1988 to 2025: implications for prevalence, mode of inheritance, relative risk associated with RYR1 genotypes, and in vitro contracture test phenotyping
Authors' conclusion
These findings support a threshold inheritance model for clinical MH, with implications for diagnostics, both genotyping and in vitro contracture test phenotyping.
Study context
- Population
- UK population; Malignant hyperthermia (MH) reactions and RYR1 variant prevalence (UK Biobank)
- Outcome
- Prevalence of the clinical risk of MH in the UK and its mode of inheritance
Methodological detailsBayesian probabilistic modelling, national data, UK Biobank data
- Bayesian probabilistic modelling
- National data
- UK Biobank data
Main finding
As reported in the abstract
- Prevalence of the risk of MH
- 1:38 800 (95% CrI 1:34 600 to 1:43 700)
- Rate of decline in MH incidence over the past 22 yr inconsistent with autosomal dominant inheritance
- P<0.33×10-5
Further findings
Probability of index cases developing MH with each anaesthetic (constant hazard; n=375)
- Constant hazard
- 0.46 (95% CI 0.42-0.50)
Risk of MH among those with 28 recurrent RYR1 variants
- Variation in risk of MH among RYR1 variants (up to)
- 125-fold
Original publication
Epidemiology of malignant hyperthermia in the UK from 1988 to 2025: implications for prevalence, mode of inheritance, relative risk associated with RYR1 genotypes, and in vitro contracture test phenotyping. Br J Anaesth. Published 22 September 2026. doi:10.
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