The Role Of Ethnicity In Heart Failure Outcomes Post Intervention

Abstract

Significance and Background Heart failure is a continuing epidemic which has become a growing health care burden. Additionally, racial disparities continue to pose a major issue in healthcare with African-Americans being 1.5 times more likely to develop heart failure than their Caucasian counterparts. Aim Considering differences in ethnically-based determinants of health, this study was undertaken to assess outcomes in ethnically different heart failure patients post discharge with respect to hypertension, diabetes, COPD, and renal insufficiency. Methods This is a single center retrospective analyses of data collected from heart failure patients of different ethnic groups in the preceding 24 months. The data collected included survival, left ventricular ejection fraction, BMI, age, gender, renal function, chronic obstructive pulmonary disease (COPD) and diabetes. The outcomes assessed included development of significant comorbidities: hypertension, diabetes, COPD, and renal insufficiency. Results The study population was 46.8% female and 53.2% male, with a mean BMI of 31.1 (obese). Hispanic patients tend to develop diabetes more than their white counterparts post intervention/discharge (p<.001). People of multiple ethnicities were most likely to develop hypertension post discharge (p=.0047). In contrast, non-Hispanic White patients were most likely to have COPD before intervention (p<.001), and to develop COPD after CHF discharge (p<.001). Conclusions The single center patient data presented here reflects racial and ethnic disparities in patients post- CHF intervention, in addition to a dangerously elevated average BMI. Racial and ethnic differences in risk of developing comorbidities post-intervention must be considered in treatment. Identification of such ethnic differences in outcomes despite intervention could possibly pave the way to develop targeted therapies in an era of personalized medicine. Heart failure is a continuing epidemic which has become a growing health care burden. Additionally, racial disparities continue to pose a major issue in healthcare with African-Americans being 1.5 times more likely to develop heart failure than their Caucasian counterparts. Considering differences in ethnically-based determinants of health, this study was undertaken to assess outcomes in ethnically different heart failure patients post discharge with respect to hypertension, diabetes, COPD, and renal insufficiency. This is a single center retrospective analyses of data collected from heart failure patients of different ethnic groups in the preceding 24 months. The data collected included survival, left ventricular ejection fraction, BMI, age, gender, renal function, chronic obstructive pulmonary disease (COPD) and diabetes. The outcomes assessed included development of significant comorbidities: hypertension, diabetes, COPD, and renal insufficiency. The study population was 46.8% female and 53.2% male, with a mean BMI of 31.1 (obese). Hispanic patients tend to develop diabetes more than their white counterparts post intervention/discharge (p<.001). People of multiple ethnicities were most likely to develop hypertension post discharge (p=.0047). In contrast, non-Hispanic White patients were most likely to have COPD before intervention (p<.001), and to develop COPD after CHF discharge (p<.001). The single center patient data presented here reflects racial and ethnic disparities in patients post- CHF intervention, in addition to a dangerously elevated average BMI. Racial and ethnic differences in risk of developing comorbidities post-intervention must be considered in treatment. Identification of such ethnic differences in outcomes despite intervention could possibly pave the way to develop targeted therapies in an era of personalized medicine.