Is heart failure in African Americans a distinct entity?

Heart failure remains a major health problem in the United States and is particularly problematic in the African American community where the disease exhibits excessive morbidity and mortality. Hypertension is a predominant etiology for heart failure among African Americans with an aggressive incidence of end-organ damage. Despite the advances in treatment of heart failure with neurohormonal attenuation, there appears to be inconsistency in the response of African Americans compared to Caucasians. This discordance with regard to response to treatment and etiology of heart failure between African Americans and Caucasians begets the question whether heart failure in African Americans is indeed a distinct clinical entity.