Abstract
Heart failure management continues to excel through evidence-based efforts. In relation to race/ethnicity, heart failure continues to disproportionately affect minorities, often with a significantly different phenotypical profile. As the evidence strengthens for heart failure management, there are rising concerns of differential effects of medical therapies for various minority groups. Even so, there are no data to suggest that any of the current medical therapies available have deleterious effects on any group of minority patients with heart failure. This chapter will evaluate the evidence for the accepted chronic therapies of heart failure management as they relate to minority patients and outcome. We will also address the selective benefits of more current race-specific evidence-based therapies.
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References
US Census Bureau. Available at: http://factfinder.census.gov/servlet/ACSSAFFPeople?_submenuId=people_10&_sse=on Accessed April 2007.
American Heart Association. 2007 Heart and Stroke Statistical Update. Dallas, TX. American Heart Association, 2007.
Shaya FT, Gbarayor CM, Yang HK, et al. A perspective on African American participation in clinical trials. Con Clin Trials 2007; 28:213–217.
Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005; 112:e154–e235.
Centers for Disease Control Diabetes fact sheet. Available at http://www.cdc.gov/diabetes/pubs/estimates05.htm. Accessed July 2007.
Centers For Disease Control Hypertension fact sheet. Available at http://www.cdc.gov/nchs/data/hus/tables/2003/03hus066.pdf. Accessed July 2007.
American Obesity Association. Available at http://obesity1.tempdomainname.com/subs/fastfacts/Obesity_Minority_Pop.shtml. Accessed July 2007.
Ferdinand KC. African American Heart Failure Trial: role of endothelial dysfunction and heart failure in African Americans. Am J Cardiol 2007; 99:3D–6D.
Cardillo C, Kilcoyne CM, Cannon RO, et al. Racial difference in nitric oxide-mediated vasodilator response to mental stress in the forearm circulation. Hypertension 1998; 31:1235–1239.
Kahn DF, Duffy SJ. Effects of black race on forearm resistance vessel function. Hypertension 2002; 40:195–201.
Carson P, Ziesche S, Johnson G, et al. Racial differences in response to therapy for heart failure: Analysis of the Vasodilator-Heart Failure Trials. J Card Fail 1999; 5:178–187.
Dries DL, Exner DV, Gersh BJ, et al. Racial differences in the outcome of left ventricular dysfunction. N Engl J Med 1999; 340:609–616.
Echols, MR, Felker GM, Thomas KL, et al. Racial differences in the characteristic of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial. J Card Fail 2006; 12:684–688.
Yancy CW. Heart failure in African Americans. Am J Cardiol 2005; 96:3i–12i.
Yancy CW. The prevention of heart failure in minority communities and discrepancies in health care delivery systems. Med Clin North Am 2004; 94:595–601.
Kressin NR, Chang BH, Whittle J, et al. Racial differences in cardiac catheterization as a function of patients’ beliefs. Am J Public Health 2004; 94:2091–2097.
Green AR, Carney DR, Pallin DJ, et al. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Inter Med 2007; 9: 1231–1238.
DuBard CA, Garrett J, Gizlice Z. Effect of language on heart attack and stroke awareness among U.S. Hispanics.Am J Prev Med 2006; 30:189–196 .
Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB. State of disparities in cardiovascular health in the United States.Circulation 2005; 111:133–141.
Rathore SS, Masoudi FA, Wang YF. Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: findings from the National Heart Failure Project. Am Heart J 2006; 152:371–378.
Conard MW, Heidenreich P, Rumsfeld JS, Weintraub WS, Spertus J Patient-reported economic burden and the health status of heart failure patients. J Card Fail 2006; 12:369–374.
Hamner JB, Ellison KJ. Predictors of hospital readmission after discharge in patients with congestive heart failure. Heart Lung 2005; 34(4):231–239.
Small KM, Wagoner LE, Levin AM, et al. Synergistic polymorphisms of b1- and a2c-adrenergic receptors and the risk of congestive heart failure. N Engl J Med 2002; 347:1135–1142.
Hein L, Altman JD, Kobilka BK. Two functionally distinct a2-adrenergic receptors regulate sympathetic neurotransmission. Nature 1999; 402:181–184.
Canham RM, Das SR, Leonard D, et al. Alpha2cDel322-325 and beta1Arg389 adrenergic polymorphisms are not associated with reduced left ventricular ejection fraction or increased left ventricular volume. J Am Coll Cardiol 2007; 49:274–276.
Malinski T. Understanding nitric oxide physiology in the heart: a nanomedical approach. Am J Cardiol 2005; 96(Suppl):13–24.
Prabhu SD. Nitric oxide protects against pathological ventricular remodeling: reconsideration of the role of NO in the failing heart.Circ Res 2004; 94:115–157.
Wollert KC, Drexler H. Regulation of cardiac remodeling by nitric oxide: focus on cardiac myocyte hypertrophy and apoptosis.Heart Fail Rev 2002; 7:317–325.
Diaber A, Oleze M, Coldeway M, et al. Hydralazine is a powerful inhibitor of peroxynitrite formation as a possible explanation for its beneficial effects on prognosis in patients with congestive heart failure. Biochem Biophys Res Commun 2005; 338(4):1865–1874.
Taylor AL, Ziesche S, et al. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med 2004; 351:2049–2057.
McNamara DM, Holubkov R, Postava L, et al. Effect of Asp298 variant of endothelial nitric oxide synthase on survival for patients with congestive heart failure. Circulation 2003; 107:1598–1602.
Tesauro M, Thompson WC, Rogliani P, et al. Intracellular processing of the endothelial nitric oxide synthase isoforms associated with differences in severity of cardiopulmonary diseases: cleavage of proteins with aspartate vs. glutamate at position 298. Proc Natl Acad Sci U S A 2000; 97:2832–2835.
McNamara DM, Tam SW, Sabolinski ML, et al. The genetic risk sub-study of the African American heart failure trial (A-HeFT): impact of genetic variations of NOS3. Abstract presented at the 2005 Heart Failure Society of America national conference. Retrieved June 22, 2006 from http://www.abstracts2view.com/hfsa05/view.php?nu=HFSA5L1_232
Weber KT. Aldosterone in congestive heart failure. N Engl J Med 2001; 345:1689–1697.
Struthers AD. Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in chronic heart failure. J Cardiol Fail 1996; 2:47–54.
Sun Y, Zhang J, Lu L, et al. Aldosterone-induced inflammation in the rat heart: role of oxidative stress. Am J Pathol 2002; 161:1773–1781.
Kotlyar E, Vita JA, Winter MR, et al. The relationship between aldosterone, oxidative stress, and inflammation in chronic, stable human heart failure. J Card Fail 2006; 12:122–127.
Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341:709–717.
Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003; 348:1309–1321.
McNamara DM, Tam W, Sabolinski ML, et al. Aldosterone synthase promoter polymorphism predicts outcome in African Americans with heart failure. J Am Coll Cardiol 2006; 48:1277–1282.
Biolo A, Chao T, Duhaney TS, et al. Usefulness of the aldosterone synthase gene polymorphism to predict cardiac remodeling in African-American and non-African-Americans with chronic systolic heart failure. Am J Cardiol 2007; 100:285–290.
Tiago AD, Badenhorst D, Skudicky D, Woodiwiss AJ, et al. An aldosterone synthase gene variant is associated with improvement in left ventricular ejection fraction in dilated cardiomyopathy. Cardiovasc Res 2002; 54:584–589.
Henderson SO, Haiman CA, Mack W. Multiple polymorphisms in the renin-angiotensin-aldosterone system (ACE, CYP11B2, AGTR1) and their contribution to hypertension in African Americans and Latinos in the multiethnic cohort. Am J Med Sci 2004; 328:266–273.
The Beta-Blocker Evaluation of Survival Trial Investigators. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med 2001; 344:1659–1667.
Shekelle PG, Rich MW, Morton SC, et al. Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status: a meta-analysis of major clinical trials. J Am Coll Cardiol 2003; 41:1529–1538.
Andreka P, Aiyar N, Olson LC, et al. Bucindolol displays intrinsic sympathomimetic activity in human myocardium. Circulation 2002; 105:2429–2434.
Yancy CW, Fowler MB, Colucci WS, et al. Race and the response to adrenergic blockade with carvedilol in patients with chronic heart failure. N Engl J Med 2001; 344: 1358–1365.
Packer M, Coats AJS, Fowler MB, et al for the Carvedilol Prospective Randomized Cumulative Survival Study Group. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001; 344:1651–1658.
MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999; 353:2001–2007.
Exner DV, Dries DL, Domanski MJ, Cohn JN. Lesser response to angiotensin-converting-enzyme inhibitor therapy in black as compared with white patients with left ventricular dysfunction. N Engl J Med 2001; 344:1351–1357.
The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342:145–153.
Julius S, Alderman MH, Beevers G, et al. Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: the LIFE study. J Am Coll Cardiol 2004; 43:1047–1055.
Julius S, Kjeldsen SE, Weber M, Brunner HR, et al for the VALUE Trial Group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomized trial. Lancet 2004; 363:2022–2031.
Cavallari LH, Fashingbauer LA, Beitelshees AL, et al. Racial differences in patients’ potassium concentration during spironolactone therapy for heart failure. Pharmacotherapy 2004; 24:750–756.
Cohn JN, Archibald MP, Ziesche S, et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure. N Engl J Med 1986; 314:1547–1552.
Pierpont GL, Cohn JN, Franciosa JA, et al. Combined oral Hydralazine-nitrate therapy in left ventricular failure: hemodynamic equivalency to sodium nitroprusside. Chest 1978; 73:8–13.
Cohn JN, Johnson G, Ziesche S., et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991; 325:303–310.
The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987; 316:1429–1435.
Kalinowski L, Dobrucki IT, Tomasian D, et al. Race-specific differences in endothelial function: Predisposition of African Americans to vascular disease. Circulation 2004; 109:2511–2517.
Unger P, Berkenboom G, Fontaine J interaction between hydralazine and nitrovasodilators in vascular smooth muscle. J Cardiovasc Pharmacol 1993; 21:478–483.
Gogia H, Mehra A, Parikh S, et al. Prevention of tolerance to hemodynamic effects of nitrates with concomitant use of hydralazine in patients with chronic heart failure. J Am Coll Cardiol 1995; 26:1575–1580.
Elkayam U, Bitar F. Effects of nitrates and hydralazine in heart failure. Clinical evidence before the African American heart failure trial. Am J Cardiol 2005; 96:37i–43i.
Taylor AL. The African American heart failure trial (A-HeFT): rationale and methodology. J Card Fail 2003; 9:S216–S219.
Taylor AL. The African American heart failure trial. A clinical trial update. Am J Cardiol 2005; 96:44i–48i.
Taylor AL, Ziesche S, Yancy CW, et al. Early and sustained benefit on event-free survival and heart failure hospitalization from fixed-dose combination of isosorbide dinitrate/hydralazine: consistency across subgroups in the African-American Heart Failure Trial. Circulation 2007; 115:1747–1753.
Gillum RF. Sudden cardiac death in Hispanic Americans and African American. Am J Public Health 1997; 87:1461–1466.
Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001; 104:2158–2163.
Russo AM, Hafley GE, Lee KL, et al. Racial differences in outcome in the multicenter unsustained tachycardia trial (MUSTT): a comparison of whites versus blacks. Circulation 2003; 108:67–72.
Vorobiof G, Goldenberg I, Moss AJ, Zareba W, McNitt S. Effectiveness of the implantable cardioverter defibrillator in blacks versus whites (from MADIT-II). Am J Cardiol 2006; 98:1383–1386.
Pamboukian SV, Costanzo MR, Meyer P, et al. Influence of race in heart failure and cardiac transplantation: mortality differences are eliminated by specialized, comprehensive care. J Card Fail 2003; 9:80–86.
Moore DE, Feurer ID, Rodgers S Jr, et al. Is there racial disparity in outcomes after solid organ transplantation? Am J Surg 2004; 188:571–574.
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Echols, M.R., Yancy, C.W. (2009). Heart Failure in Racial/Ethnic Groups. In: Ferdinand, K., Armani, A. (eds) Cardiovascular Disease in Racial and Ethnic Minorities. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59745-410-0_14
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DOI: https://doi.org/10.1007/978-1-59745-410-0_14
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