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Review
. 2019 Jan-Dec:13:1753944719840192.
doi: 10.1177/1753944719840192.

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

Frank Tillman  1 , Jennifer Kim  2 , Tanya Makhlouf  3 , Leah Osae  3
Affiliations
Review

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans

Frank Tillman et al. Ther Adv Cardiovasc Dis. 2019 Jan-Dec.

Abstract

Background: Our aim was to review the published literature evaluating treatment approaches for chronic heart failure (HF), notably as it relates to African American patients.

Method: We undertook a comprehensive database search (1986-2017) of PubMed, EMBASE, and Ovid/MEDLINE utilizing terms 'African American', 'black', 'chronic heart failure', 'heart failure', 'medication', 'chronic therapy', and 'clinical trials'. Additional notable studies were obtained from ClinicalTrials.gov . Studies published in English that examine treatment modalities of chronic HF in African American and non-African American patients were included.

Results: Examples of current gaps worthy of investigation include whether to maximize thiazides and calcium-channel blockers prior to adding renin-angiotensin system (RAS) inhibitors or beta blockers in HF with preserved ejection fraction; whether hydralazine/isosorbide dinitrate (ISDN) should be initiated during earlier HF stages; whether to prioritize hydralazine/ISDN over other agents such as RAS inhibitors; varying response of African Americans to different agents within drug classes; and the role of mineralocorticoid receptor antagonists.

Conclusion: Further studies are needed in order for consensus guidelines to clarify how best to treat this population.

Keywords: African American; chronic heart failure; clinical trials; pharmacological treatment; under-representation.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

References

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