Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Cardiology, Sarver Heart Center, University of Arizona, Tucson, Arizona, USA.
Curr Opin Cardiol. 2021 May 1;36(3):320-328. doi: 10.1097/HCO.0000000000000855.
This review discusses the current state of racial and ethnic inequities in heart failure burden, outcomes, and management. This review also frames considerations for bridging disparities to optimize quality heart failure care across diverse communities.
Treatment options for heart failure have diversified and overall heart failure survival has improved with the advent of effective pharmacologic and nonpharmacologic therapies. With increased recognition, some racial/ethnic disparity gaps have narrowed whereas others in heart failure outcomes, utilization of therapies, and advanced therapy access persist or worsen.
Racial and ethnic minorities have the highest incidence, prevalence, and hospitalization rates from heart failure. In spite of improved therapies and overall survival, the mortality disparity gap in African American patients has widened over time. Racial/ethnic inequities in access to cardiovascular care, utilization of efficacious guideline-directed heart failure therapies, and allocation of advanced therapies may contribute to disparate outcomes. Strategic and earnest interventions considering social and structural determinants of health are critically needed to bridge racial/ethnic disparities, increase dissemination, and implementation of preventive and therapeutic measures, and collectively improve the health and longevity of patients with heart failure.
本文讨论了心力衰竭负担、结局和管理方面的种族和民族差异现状。本综述还提出了一些考虑因素，以缩小差距，优化不同人群的心力衰竭优质护理。
随着有效药物和非药物治疗方法的出现，心力衰竭的治疗选择已经多样化，整体心力衰竭生存率也有所提高。随着认识的提高，一些种族/民族差异在心力衰竭结局、治疗方法的使用和先进治疗方法的可及性方面有所缩小，但其他方面的差异仍然存在或恶化。
少数民族的心力衰竭发病率、患病率和住院率最高。尽管治疗方法有所改善，整体生存率也有所提高，但非裔美国人患者的死亡率差距随着时间的推移而扩大。在心血管护理的可及性、有效指南指导的心力衰竭治疗方法的使用以及先进治疗方法的分配方面，存在种族/民族差异，这可能导致结局不同。需要采取战略性和认真的干预措施，考虑健康的社会和结构性决定因素，以缩小种族/民族差异，增加预防和治疗措施的传播和实施，并共同提高心力衰竭患者的健康和寿命。
