The role of race in heart failure therapy.

Heart failure in blacks is a unique malady characterized by a different natural history, more worrisome prognosis, and potential variances in the response to current medical therapy for heart failure. The overwhelming burden of hypertension as a putative cause of left ventricular dysfunction identifies this illness. Although differences in the response to medical therapy have been described, angiotensin-converting enzyme inhibitors and beta-blockers remain the most appropriate therapy. Certain genetic polymorphisms may exist that explain the observed differences.