Clinical Differences In Hispanic Americans With Heart Failure.

Data presented from the world’s largest heart failure registry known as ADHERE (Acute Decompensated Heart Failure National Registry) indicate that Hispanic Americans may have higher rates of diabetes and higher cholesterol levels than African American and Caucasian patients who are admitted to the hospital for heart failure. These data were presented at the American Heart Association (AHA) Scientific Sessions 2004 in New Orleans.

“For the first time we have data that clearly show there may be differences in how Hispanic Americans present with heart failure compared to other ethnic groups,” said Javier Jimenez, M.D., Assistant Professor of Medicine at the University of Miami/Jackson Memorial Medical Center in Miami, Fla., and lead author of the study. “We need to understand how genetic and
cultural differences play a part in patient care if we are to improve heart failure patient treatment and outcomes.”

The new ADHERE(R) observational analysis provides a first-time glimpse of how the hospital treatment, outcomes and presenting clinical characteristics of Hispanic Americans may differ from those of African American and Caucasian heart failure patients. The study evaluated patients from the three ethnic groups who were admitted to ADHERE -participating hospitals between October 2001 and February 2003 and who were diagnosed with acutely decompensated
congestive heart failure.

According to the ADHERE observational analysis, Hispanic Americans more often were male and had a higher incidence of diabetes and high cholesterol than African American or Caucasian heart failure patient cases in the study.

“It is important to act now to identify the gaps in heart failure care and outcomes among different ethnic groups, otherwise we risk allowing these gaps to widen rather than be eliminated,” said Clyde W. Yancy, M.D., Professor of Medicine & Cardiology, Director of Congestive Heart Failure/Heart Transplant Program at University of Texas Southwestern Medical Center, Dallas, and supporting author of the study. “Currently, the ADHERE database indicates that Hispanic Americans constitute no more than 3% of the overall population affected with heart failure, but given the high penetration of cardiovascular risk factors and the growing Hispanic American population, the problem of heart failure is likely to grow in this group. ADHERE(R) offers us the opportunity to determine the gaps in heart failure care that influence how patients present and are treated with the disease, and how to close them.”

A previous analysis of the observational data from ADHERE showed that there is significant variation in the in-hospital care afforded to acute heart failure patients nationwide. According to the study presented during the AHA Scientific Sessions 2003, less than one-third of patients hospitalized with heart failure are provided with educational counseling and guideline- recommended angiotensin-converting-enzyme inhibitors (blood pressure-lowering medications) prior to discharge.

The National Institutes of Health characterizes congestive heart failure (CHF) as an epidemic affecting nearly 5 million Americans, and it is the most common discharge diagnosis in hospital patients age 65 and older.(1) According to the U.S. Department of Health and Human Services, the number of Americans older than age 65 is expected to increase by nearly one-third during the next two decades, with proportions of minorities in the overall population increasing from 11.4% to 16.3% for Hispanic Americans and 12.9% to 14.0% for African Americans. At its current rate, the population of heart disease survivors is expected to grow at a much faster rate than the U.S. population as a whole.(2)

(1) National Institutes of Health, National Heart, Lung, and Blood Institute, Data Fact Sheet, Congestive Heart Failure in the United States: A New Epidemic, September 1996.

(2) The U.S. Department of Health and Human Services Centers for Disease Control and Prevention, A Public Health Action Plan to Prevent Heart Disease and Stroke, http://www.cdc.gov/cvh/Action_Plan/