Racial/Ethnic and Gender Disparities in Heart Failure with Reduced Ejection Fraction

Mwansa, Hunter; Lewsey, Sabra C.; Mazimba, Sula; Breathett, Khadijah

doi:10.1007/s11897-021-00502-5

Cited by 33 publications

(57 citation statements)

References 86 publications

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“…The racial and geographic disparities observed in our study may relate to inequitable access to HF therapies. 11 Consistent with recent NIS analyses showing an increasing trend of HF hospitalization since 2014, 12,13 we show similar findings, but we also show that despite this trend, in-hospital mortality for HF hospitalization has been declining. We also show that this trend is consistent regardless of the sex or age group.…”

Section: Discussionsupporting

confidence: 92%

Trends and characteristics of hospitalizations for heart failure in the United States from 2004 to 2018

et al. 2022

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Aims Hospitalization for heart failure (HF) constitutes a major healthcare and economic burden. Trends and characteristics of hospitalizations for HF for the recent years are not clear. We sought to determine the trends and characteristics of hospitalization for HF in the United States. Method and results A retrospective analysis of the National Inpatient Sample weighted data between 1 January 2004 and 31 December 2018, which included hospitalized adults ≥ 18 years with primary discharge diagnosis of HF using International Classification of Diseases-9/10 administrative codes. Main outcomes were trends in hospitalizations for HF (per 1000 person) and inpatient mortality (%) between 2004 and 2018. Conclusions Hospitalizations for HF have been increasing across both sexes and age groups since 2013, whereas inpatient mortality has been decreasing over the study period. Blacks have the highest risk of hospitalization for HF, and Whites have the highest in-hospital mortality. There are significant racial and geographic disparities related to hospitalizations for HF.

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Section: Discussionsupporting

confidence: 92%

Trends and characteristics of hospitalizations for heart failure in the United States from 2004 to 2018

et al. 2022

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“…[ 38 , 59 ] Loan forgiveness programmes may improve the diversity of the CV clinical and research workforce. [ 60 ] Pragmatic clinical trial designs in non-traditional settings, such as churches and barbershops, may aid a diverse recruitment in clinical trials. [ 61 ] These settings may be more accessible to Black and Hispanic patients and provide clinical trial results that can be easily applicable in real-world and clinical-practice settings.…”

Section: Strategies To Improve Gdmt In Hf For Black Hispanic and Amer...mentioning

confidence: 99%

Unequitable Heart Failure Therapy for Black, Hispanic and American-Indian Patients

2022

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Despite the high prevalence of heart failure among Black and Hispanic populations, patients of colour are frequently under-prescribed guideline-directed medical therapy (GDMT) and American-Indian populations are not well characterised. Clinical inertia, financial toxicity, underrepresentation in trials, non-trustworthy medical systems, bias and structural racism are contributing factors. There is an urgent need to develop evidence-based strategies to increase the uptake of GDMT for heart failure in patients of colour. Postulated strategies include prescribing all GDMT upon first encounter, aggressive outpatient uptitration of GDMT, intervening upon social determinants of health, addressing bias and racism through changing processes or policies that unfairly disadvantage patients of colour, engagement of stakeholders and implementation of national quality improvement programmes.

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“…In a multicenter retrospective analysis, 73.4% of referrals evaluating candidacy for advanced therapies were men ( 37 ). Women are allocated to less than a third of HT and LVAD in the US ( 38 ) and are under-represented in HF clinical trials ( 5 , 7 , 10 ).…”

Section: Life Sustaining Therapies For Women With Advanced Heart Failurementioning

confidence: 99%

Special Considerations in the Care of Women With Advanced Heart Failure

Ebong

DeFilippis

Hamad

et al. 2022

Front. Cardiovasc. Med.

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Advanced heart failure (AHF) is associated with increased morbidity and mortality, and greater healthcare utilization. Recognition requires a thorough clinical assessment and appropriate risk stratification. There are persisting inequities in the allocation of AHF therapies. Women are less likely to be referred for evaluation of candidacy for heart transplantation or left ventricular assist device despite facing a higher risk of AHF-related mortality. Sex-specific risk factors influence progression to advanced disease and should be considered when evaluating women for advanced therapies. The purpose of this review is to discuss the role of sex hormones on the pathophysiology of AHF, describe the clinical presentation, diagnostic evaluation and definitive therapies of AHF in women with special attention to pregnancy, lactation, contraception and menopause. Future studies are needed to address areas of equipoise in the care of women with AHF.

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Racial/Ethnic and Gender Disparities in Heart Failure with Reduced Ejection Fraction

Cited by 33 publications

References 86 publications

Trends and characteristics of hospitalizations for heart failure in the United States from 2004 to 2018

Trends and characteristics of hospitalizations for heart failure in the United States from 2004 to 2018

Unequitable Heart Failure Therapy for Black, Hispanic and American-Indian Patients

Special Considerations in the Care of Women With Advanced Heart Failure

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