Heart failure in African Americans: disparities can be overcome.
African Americans are disproportionately affected by heart failure, with a high prevalence at an early age. Hypertension, diabetes, obesity, and chronic kidney disease are all common in African Americans and all predispose to heart failure. Neurohormonal imbalances, endothelial dysfunction, genetic polymorphisms, and socioeconomic factors also contribute. In general, the same evidence-based treatment guidelines that apply to white patients with heart failure also apply to African Americans. However, the combination of hydralazine and isosorbide dinitrate is advised specifically for African Americans.
Fellow, Cardiovascular Division, University of Minnesota, Minneapolis.
Alok
A
Sharma
Monica
M
Colvin-Adams
Clyde W
CW
Yancy
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; D002316:Cardiotonic Agents / Q000627:therapeutic use; D017147:Defibrillators, Implantable; D004077:Digoxin / Q000627:therapeutic use; D004338:Drug Combinations; D054624:Health Status Disparities; D006333:Heart Failure / Q000208:ethnology* / Q000235:genetics / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D006973:Hypertension / Q000208:ethnology / Q000517:prevention & control*; D015994:Incidence; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D015995:Prevalence; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002316:Cardiotonic Agents; D004338:Drug Combinations; D000451:Mineralocorticoid Receptor Antagonists; D014665:Vasodilator Agents; C431665:isosorbide-hydralazine combination; D006830:Hydralazine; D004077:Digoxin; D007548:Isosorbide Dinitrate