Yes, different ethnic groups appear to have different incidences of CHF. Further, different ethnic groups appear to use medical services at different rates. For example, studies indicate that African-Americans suffer a disproportionate incidence of cardiovascular disease. With respect to heart failure, they are affected at a rate almost twice the rate of the corresponding white population and are more likely to die from it at a younger age.
This dramatic ethnic difference in health outcomes has been attributed to a variety of factors, including access to medical care, management of heart failure, and socioeconomic factors. Recent analyses of heart failure clinical trials, however, show that the mortality rate and the hospitalization rate for African-Americans is significantly higher than that of non-African-Americans, even after adjustment for such factors. In fact, black heart-failure patients also have different morbidity and mortality than do whites, dying at a rate 40–50 percent faster than the corresponding white population.
There are clinical data that suggest that hypertension in African-Americans is less well controlled with an-giotensin-converting-enzyme (ACE) inhibitor therapy. Thus, different medication regimens may be necessary to control this disease in African-Americans. (See the medication BiDil in question number 47.) When compared to other ethnic groups, African-Americans had the highest rate of CHF hospitalization.
Age-adjusted hospitalization rates were com-parable among whites, Latinos, and Asian women and all were lower than those for African-Americans. Overall, Asian men had the lowest rates. On adjusted analyses, African-Americans were more likely than whites and Asians to be rehospitalized. Based on data from the U.S. Census Bureau and the Centers for Disease Control and Prevention, scientists estimate that 750,000 African-Americans have been diagnosed with heart failure. They expect this number to grow to approximately 900,000 persons by 2010.