Racial differences in patients with heart failure

Background and hypothesis: Limited data exist regarding racial differences in heart failure. The objective of this prospective study was to document r acial differences in the baseline demographics and patterns of health care utilization and outcomes in patients with heart failure. Methods: The data on 163 consecutive patients (113 black, 50 white) admitte d with a diagnosis of heart failure confirmed by pulmonary congestion on ch est x-ray were prospectively evaluated. Patient demographics, physical exam ination findings at admission, comorbid conditions, and medications at admi ssion and discharge were analyzed. Follow-up was performed to document visi ts to the physician's office after discharge and readmission rate during a 6-month time period. Results: Compared with whites, blacks were younger in age (mean age 63.8 +/ - 13.7 years vs. 70.8 +/- 13.1, p = 0.003), and had a higher prevalence of hypertension (86 vs. 66%, p = 0.004), left ventricular hypertrophy (24 vs. 8%, p = 0.02), ejection fraction <40% (64 vs. 43%, p = 0.03), and readmissi on rate (33 vs. 18%, p = 0.05). Whites had a higher prevalence of atrial fi brillation (42 vs. 21%, p = 0.006) and more frequently followed up with the ir cardiologists as outpatients (58 vs. 39%, p = 0.04). Conclusion: Significant racial differences exist in patients with heart fai lure with regard to age, incidence, etiologic factors, left ventricular hyp ertrophy, left ventricular function, and clinical follow-up. It is importan t to consider these racial differences in the evaluation and management of patients with heart failure.