Comparison of African-American patients with systolic heart failure versus preserved ejection fraction.
Evidence exists for race-specific differences in the cause and natural history of heart failure (HF). These differences may have important treatment implications, but relatively limited data on African-Americans exist. A cohort of 89 African-American patients admitted to an urban teaching hospital with diagnoses of HF was examined. Most patients had systolic HF (71%), and the remainder had HF with preserved ejection fractions (EFs). Patients with HF with preserved EFs tended to be generally older (67 vs 57 years, p = 0.01) and were more likely to be women (69% vs 42%, p = 0.02). There were no significant differences between patients with systolic HF and those with HF with preserved EFs in the prevalence of coronary artery disease (23%), diabetes mellitus (44%), or chronic obstructive pulmonary disease (38%). Gastrointestinal bleeding and anemia were significant contributors to admission in patients with preserved EFs, with baseline hematocrits being significantly lower (34.9 vs 38.3, p = 0.01). On discharge, patients with HF with preserved EFs were less likely to be prescribed angiotensin-converting enzyme inhibitors than patients with systolic HF (65% vs 83%, p = 0.08) or diuretics (58% vs 82.%, p = 0.03). In conclusion, differences exist in African-American patients who present with HF; optimal therapeutic approaches will require a better understanding of their underlying pathophysiology.
Ilksoy
Nurcan
N
Emory University School of Medicine, Department of Medicine, Atlanta, Georgia, USA. nilksoy@emory.edu
Hoffman
Matt
M
Moore
Renee H
RH
Easley
Kirk
K
Jacobson
Terry A
TA
D001741:Black or African American; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications
D000806:Angiotensin-Converting Enzyme Inhibitors