Representation of Black patients in heart failure clinical trials
- PMID: 33818547
- DOI: 10.1097/HCO.0000000000000849
Representation of Black patients in heart failure clinical trials
Abstract
Purpose of review: Black patients with heart failure in the United States are underrepresented in clinical trials relative to their overrepresentation in the heart failure population and in adverse heart failure outcomes. We aim to evaluate historical trends in this space and highlight recent developments.
Recent findings: Multiple landmark heart failure trials published since 2019 have underrepresented Black patients, though several discussed this lack of representation as limitations. A review of large heart failure clinical trials from 2001 to 2016 found persistent underrepresentation of Black patients without significant change over time. Trials enrolling from North America exclusively had more proportional representation, enrolling an average of 31.6% Black participants.
Summary: There is a shrinking proportion of Black patients in pivotal heart failure trials despite a higher prevalence of disease and associated adverse outcomes. There is increasing awareness of these disparities within the heart failure community, potentially leading to improved representation in future studies.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Similar articles
-
Racial and ethnic underrepresentation in dermatology clinical trials.J Am Acad Dermatol. 2023 Aug;89(2):293-300. doi: 10.1016/j.jaad.2023.04.011. Epub 2023 Apr 14. J Am Acad Dermatol. 2023. PMID: 37062462
-
A Critical Evaluation of the Representation of Black Patients With Heart Failure and Preserved Ejection Fraction in Clinical Trials: A Literature Review.J Cardiovasc Nurs. 2016 May-Jun;31(3):202-8. doi: 10.1097/JCN.0000000000000237. J Cardiovasc Nurs. 2016. PMID: 25658183 Review.
-
Association of Race With Disease Expression and Clinical Outcomes Among Patients With Hypertrophic Cardiomyopathy.JAMA Cardiol. 2020 Jan 1;5(1):83-91. doi: 10.1001/jamacardio.2019.4638. JAMA Cardiol. 2020. PMID: 31799990 Free PMC article.
-
Treatment of heart failure in African Americans--a call to action.J Natl Med Assoc. 2011 Feb;103(2):86-98. doi: 10.1016/s0027-9684(15)30257-1. J Natl Med Assoc. 2011. PMID: 21443060
-
Diversity in modern heart failure trials: Where are we, and where are we going.Int J Cardiol. 2022 Feb 1;348:95-101. doi: 10.1016/j.ijcard.2021.12.018. Epub 2021 Dec 15. Int J Cardiol. 2022. PMID: 34920047 Free PMC article. Review.
Cited by
-
Race, Genetics, and Social Determinants of Health in Transthyretin Cardiac Amyloidosis: A Literature Review and Call to Action.Curr Cardiol Rep. 2025 Mar 5;27(1):66. doi: 10.1007/s11886-025-02220-z. Curr Cardiol Rep. 2025. PMID: 40042763 Review.
-
Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates.J Am Coll Cardiol. 2022 Aug 9;80(6):565-578. doi: 10.1016/j.jacc.2022.05.033. J Am Coll Cardiol. 2022. PMID: 35926929 Free PMC article.
-
Sarcopenic Obesity Is Associated With Reduced Cardiorespiratory Fitness Compared With Nonsarcopenic Obesity in Patients With Heart Failure With Reduced Ejection Fraction.Circ Heart Fail. 2022 Oct;15(10):e009518. doi: 10.1161/CIRCHEARTFAILURE.122.009518. Epub 2022 Sep 13. Circ Heart Fail. 2022. PMID: 36098058 Free PMC article.
-
Opportunities to Improve Long COVID Care: Implications from Semi-structured Interviews with Black Patients.Patient. 2022 Nov;15(6):715-728. doi: 10.1007/s40271-022-00594-8. Epub 2022 Jul 30. Patient. 2022. PMID: 35907120 Free PMC article.
References
-
- Gillum R. Heart failure in the United States 1970–1985. Am Heart J 1987; 113:1043–1045.
-
- Dyke MV. Heart disease death rates among Blacks and Whites aged ≥35 years – United States, 1968–2015. MMWR Surveill Summ 2018; 67:1–11.
-
- Ghali JK, Cooper R, Ford E. Trends in hospitalization rates for heart failure in the United States, 1973–1986. Evidence for increasing population prevalence. Arch Intern Med 1990; 150:769–773.
-
- Ziaeian B, Kominski Gerald F, Ong Michael K, et al. National differences in trends for heart failure hospitalizations by sex and race/ethnicity. Circ Cardiovasc Qual Outcomes 2017; 10:e003552.
-
- Duma N, Azam T, Riaz IB, et al. Representation of minorities and elderly patients in multiple myeloma clinical trials. Oncologist 2018; 23:1076–1078.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials