Race and Ethnicity in Heart Failure JACC Focus Seminar 8/9

Heart failure (HF) affects >6 million Americans, with variations in incidence, prevalence, and clinical outcomes by race/ethnicity. Black adults have the highest risk for HF, with earlier age of onset and the highest risk of death and hospitalizations. The risk of hospitalizations for Hispanic patients is higher than White patients. Data on HF in Asian individuals are more limited. However, the higher burden of traditional cardiovascular risk factors, particularly among South Asian adults, is associated with increased risk of HF. The role of environmental, socioeconomic, and other social determinants of health, more likely for Black and Hispanic patients, are increasingly recognized as independent risk factors for HF and worse outcomes. Structural racism and implicit bias are drivers of health care disparities in the United States. This paper will review the clinical, physiological, and social determinants of HF risk, unique for race/ethnic minorities, and offer solutions to address systems of inequality that need to be recognized and dismantled/eradicated. (C) 2021 by the American College of Cardiology Foundation.

Automated summary

Heart failure affects over 6 million Americans, with disparities in incidence, prevalence, and outcomes among different race/ethnic groups. Black adults have the highest risk, with earlier onset and higher mortality and hospitalization rates. Hispanics also have a higher risk of hospitalizations compared to White patients. Limited data on Asian individuals, but increased cardiovascular risk factors among South Asians are associated with higher HF risk. Structural racism and implicit bias contribute to healthcare disparities in the US.