Heart failure management in African Americans: meeting the challenge.
Heart failure affects 3% of African Americans. The etiology of disease and prognosis for these patients differs substantially from those for non-African Americans. A history of hypertension is associated with development of heart failure more often in African Americans than in non-African Americans and it also appears that target organ involvement is more severe in African Americans with hypertension than in other patient subgroups. Reviewing the results from large-scale clinical end point studies suggests that optimal treatment for heart failure in African Americans may differ from that of their non-African American counterparts. More importantly, concomitant use of beta blockers and angiotensin-converting enzyme inhibitors may be as effective in African Americans as in non-African Americans. Utilizing angiotensin-converting enzyme inhibitors alone may not represent ideal therapy. Of the drugs studied, especially among the beta blockers, carvedilol may be the most effective to use for this population.
Durand
Jean-Bernard
JB
M.D. Anderson Cancer Center, University of Texas, 1515 Holcombe Boulevard No. 449, Houston, TX 77030-4009, USA. jdurand@mdanderson.org
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001741:Black or African American / Q000235:genetics / Q000706:statistics & numerical data; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000208:ethnology / Q000235:genetics; D006801:Humans; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors