Shedding New Light on Heart Failure in African Americans
Heart failure cuts across all ethnicities, affecting about 5 million people in this country. But African Americans suffer nearly twice the rate of heart failure as Caucasians. They also are more than twice as likely to die from the disease.
Experts are just now beginning to understand the physiology behind these risks. Fortunately, a new medication that combines two established drugs may offer African Americans increased protection against heart failure.
Understanding the Threat
Heart failure is not due to aging. It is caused by conditions that damage the heart or make it work less efficiently.
In Caucasians, coronary artery disease, including heart attack, is the most common cause of heart failure. In African Americans, heart failure is most often caused by high blood pressure. Diabetes and kidney disease also may be to blame. In addition, African Americans are more likely to develop and die earlier from heart failure than Caucasians, according to Thierry Momplaisir, M.D., an interventional cardiologist on staff at Our Lady of Lourdes Medical Center.
"There have been tremendous advances in drugs and devices for managing chronic heart failure and reducing the mortality rate," Dr. Momplaisir said. "But the clinical trials for these drugs and devices included few women, African Americans or other minorities."
Ann Townsend, M.S.N., A.P.N.-C., Director of the Lourdes Heart Failure Center at Our Lady of Lourdes Medical Center, said one reason African Americans may develop heart failure earlier is that they may produce less nitric oxide, making traditional therapies like ACE inhibitors and beta-blockers less effective.
"We're really just beginning to understand the biochemical differences," Townsend said.
A New Hope
The U.S. Food and Drug Administration recently approved a medicine called BiDil based on a study that focused only on African Americans. In this study, patients on BiDil cut their risk of death from heart failure almost in half. They also were hospitalized less often for the disease and experienced fewer symptoms.
BiDil is a combination of two drugs, hydralazine and isosorbide, that relax the blood vessels, making it easier for a weakened heart to keep blood flowing and release nitric oxide.
"This drug should strongly be considered as a therapy for African-American patients with heart failure," Dr. Momplaisir said.
If you have heart failure, learn treatment options and coping tips from our FREE brochure, African Americans Living with Heart Failure. To order, call 1-888-LOURDES (568-7337).