Racial and ethnic disparities in heart failure: current state and future directions.
Racial and ethnic disparities in heart failure: current state and future directions.
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DOI：
10.1097/hco.0000000000000855
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发表时间：
2021-05-01
影响因子：
2.3
通讯作者：
Breathett K
中科院分区：
文献类型：
--
作者：
Lewsey SC;Breathett K
这篇综述讨论了种族和民族不平等在心力衰竭负担、结果和管理方面的现状。这篇综述还提出了弥合差异的考虑因素，以优化不同社区的高质量心力衰竭护理。心力衰竭的治疗选择多样化，随着有效的药理学和非药理学疗法的出现，心力衰竭的总体存活率得到了改善。随着认知度的提高，一些种族/民族差距缩小了，而另一些人在心力衰竭结局、治疗方法的利用和先进治疗机会方面的差距持续或恶化。种族和少数民族因心力衰竭的发病率、患病率和住院率最高。尽管改善了治疗方法和总体存活率，但非洲裔美国人患者的死亡率差距随着时间的推移而扩大。在获得心血管护理方面的种族/民族不平等，使用有效的指南指导的心力衰竭治疗，以及分配先进的治疗方法，可能导致不同的结果。考虑到健康的社会和结构决定因素的战略性和认真的干预至关重要，以弥合种族/民族差异，增加预防和治疗措施的传播和实施，并共同改善心力衰竭患者的健康和寿命。
This review discusses the current state of racial and ethnic inequities in heart failure burden, outcomes, and management. This review also frames considerations for bridging disparities to optimize quality heart failure care across diverse communities. Treatment options for heart failure have diversified and overall heart failure survival has improved with the advent of effective pharmacologic and non-pharmacologic therapies. With increased recognition, some racial/ethnic disparity gaps have narrowed whereas others in heart failure outcomes, utilization of therapies, and advanced therapy access persist or worsen. Racial and ethnic minorities have the highest incidence, prevalence, and hospitalization rates from heart failure. In spite of improved therapies and overall survival, the mortality disparity gap in African American patients has widened over time. Racial/ethnic inequities in access to cardiovascular care, utilization of efficacious guideline-directed heart failure therapies, and allocation of advanced therapies may contribute to disparate outcomes. Strategic and earnest interventions considering social and structural determinants of health are critically needed to bridge racial/ethnic disparities, increase dissemination and implementation of preventative and therapeutic measures, and collectively improve the health and longevity of patients with heart failure.