Contemporary treatment of heart failure: is there adequate evidence to support a unique strategy for African-Americans? Con position.
Heart failure is a substantial cause of increased morbidity and mortality in the African-American population, with poorer prognosis versus white patients. Systolic heart failure is predominantly caused by poorly controlled hypertension in African-Americans. Overall, African-Americans remain underrepresented in morbidity and mortality heart failure trials, and further data are needed to confirm the potential benefit of present therapies and newer approaches to heart failure in African-Americans. Intensive blood pressure control and control of other risk factors, along with the appropriate application of evidence-based therapies including angiotensin converting enzyme (ACE) inhibitors and approved beta-blockers, are required to decrease racial disparities. Although some data suggest that contemporary treatment with ACE inhibitors and beta-blockers may be less effective in African-Americans in terms of reducing heart failure morbidity and mortality, there is not adequate evidence to support a unique strategy for this population. The use of evidence-based therapies should be equally applied to African-Americans as well as to other ethnic groups while awaiting further studies.
Heartbeats Life Center, Xavier University of Louisiana, College of Pharmacy, 1201 Poland Avenue, New Orleans, LA 70117, USA. heartbeatslifecenter@salu.net
Keith C
KC
Ferdinand
Claudia C
CC
Serrano
Daphne P
DP
Ferdinand
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001741:Black or African American; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy / Q000208:ethnology; D006333:Heart Failure / Q000188:drug therapy* / Q000208:ethnology*; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D006830:Hydralazine; D007548:Isosorbide Dinitrate