J Card Fail. 2022 Jul;28(7):1169-1184. doi: 10.1016/j.cardfail.2022.04.008. Epub 2022 May 17.
Heart failure (HF) remains a condition associated with high morbidity, mortality, and associated costs. Although the number of medical and device-based therapies available to treat HF are expanding at a remarkable rate, disparities in the risk for incident HF and treatments delivered to patients are also of growing concern. These disparities span across racial and ethnic groups, socioeconomic status, and apply across the spectrum of HF from stage A to stage D. The complexity of HF risk and treatment is further impacted by the number of patients who experience the downstream impact of social determinants of health. The purpose of this document is to highlight the known health care disparities that exist in the care of patients with HF and to provide a context for how clinicians and researchers should assess both biological and social determinants of HF risk in vulnerable populations. Furthermore, this document provides a framework for future steps that can be used to help diminish inequalities in access and clinical outcomes over time, and offer solutions to help decrease disparities within HF care.
心力衰竭(HF)仍然是一种与高发病率、死亡率和相关成本相关的疾病。尽管可用于治疗 HF 的医学和设备治疗方法的数量正在以惊人的速度增加,但 HF 发病风险和患者接受治疗的差异也越来越令人担忧。这些差异跨越了种族和族裔群体、社会经济地位,并适用于从 A 期到 D 期的整个 HF 谱。HF 风险和治疗的复杂性还受到许多患者遭受健康的社会决定因素的下游影响的影响。本文档的目的是强调在 HF 患者护理中存在的已知医疗保健差异,并为临床医生和研究人员如何评估弱势人群中 HF 风险的生物和社会决定因素提供背景。此外,本文档还提供了一个框架,可用于帮助随着时间的推移减少获得和临床结果方面的不平等,并提供解决方案以帮助减少 HF 护理中的差异。