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Heart failure in blacks: etiologic and epidemiologic differences.

¹Heart Failure/Cardiac Transplantation, University of Texas Southwestern Medical School, Dallas, TX 75390, USA. clyde.yancy@utsouthwestern.edu

Current Cardiology Reports

|April 18, 2001

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Heart failure disproportionately affects Black Americans, presenting with more severe left ventricular dysfunction and higher mortality. Unique neurohormonal differences may explain these disparities and offer new therapeutic targets.

Area of Science:

Cardiology
Cardiovascular Disease
Health Disparities

Background:

Heart failure (HF) in Black Americans is a significant clinical challenge.
Hypertension is a primary cause of left ventricular (LV) dysfunction in over 60% of Black HF patients, compared to 30% with coronary artery disease.
Black patients with HF experience worse outcomes, including advanced LV dysfunction, higher hospitalization rates, and at least 30% higher mortality than White Americans.

Purpose of the Study:

To investigate the unique factors contributing to the distinct natural history of heart failure in Black Americans.
To explore potential therapeutic targets based on observed differences in disease progression and outcomes.

Main Methods:

This study is a review of existing data and clinical observations regarding heart failure in Black Americans.

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Analysis focuses on the prevalence of contributing factors like hypertension and coronary artery disease.

Comparison of disease severity, hospitalization, and mortality rates between Black and White American heart failure patients.

Main Results:

Black Americans with heart failure exhibit more advanced left ventricular dysfunction.
Hospitalization and mortality rates are significantly higher in Black patients compared to White patients.
Conventional treatments have shown inconsistent efficacy in this population.

Conclusions:

Socioeconomic factors do not appear to fully explain the observed disparities in heart failure outcomes.
Unique alterations in the neurohormonal environment are hypothesized to underlie the differences in heart failure progression and severity in Black Americans.
Identifying these neurohormonal perturbations may lead to novel therapeutic strategies for heart failure in this demographic.