Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction.

Harsh Golwala, Udho Thadani, L. Liang, Stavros Stavrakis, Javed Butler, Clyde W. Yancy, Deepak L. Bhatt, Adrian F. Hernandez, Gregg C. Fonarow

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Hydralazine-isosorbide dinitrate (H-ISDN) therapy is recommended for African American patients with moderate to severe heart failure with reduced ejection fraction (<40%) (HFrEF), but use, temporal trends, and clinical characteristics associated with H-ISDN therapy in clinical practice are unknown. An observational analysis of 54 622 patients admitted with HFrEF and discharged home from 207 hospitals participating in the Get With The Guidelines-Heart Failure registry from April 2008 to March 2012 was conducted to assess prescription, trends, and predictors of use of H-ISDN among eligible patients. Among 11 185 African American patients eligible for H-ISDN therapy, only 2500 (22.4%) received H-ISDN therapy at discharge. In the overall eligible population, 5115 of 43 498 (12.6%) received H-ISDN at discharge. Treatment rates increased over the study period from 16% to 24% among African Americans and from 10% to 13% among the entire HFrEF population. In a multivariable model, factors associated with H-ISDN use among the entire cohort included younger age; male sex; African American/Hispanic ethnicity; and history of diabetes, hypertension, anemia, renal insufficiency, higher systolic blood pressure, and lower heart rate. In African American patients, these factors were similar; in addition, being uninsured was associated with lower use. Overall, few potentially eligible patients with HFrEF are treated with H-ISDN, and among African-Americans fewer than one-fourth of eligible patients received guideline-recommended H-ISDN therapy. Improved ways to facilitate use of H-ISDN therapy in African American patients with HFrEF are needed.

Original languageEnglish (US)
JournalJournal of the American Heart Association
Volume2
Issue number4
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

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Isosorbide Dinitrate
Hydralazine
Ethnic Groups
African Americans
Stroke Volume
Heart Failure
Therapeutics
isosorbide-hydralazine combination
Guidelines
Hypertension
Hispanic Americans
Population
Renal Insufficiency
Prescriptions
Registries
Anemia
Heart Rate
Blood Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction. / Golwala, Harsh; Thadani, Udho; Liang, L.; Stavrakis, Stavros; Butler, Javed; Yancy, Clyde W.; Bhatt, Deepak L.; Hernandez, Adrian F.; Fonarow, Gregg C.

In: Journal of the American Heart Association, Vol. 2, No. 4, 01.01.2013.

Research output: Contribution to journalArticle

Golwala, Harsh ; Thadani, Udho ; Liang, L. ; Stavrakis, Stavros ; Butler, Javed ; Yancy, Clyde W. ; Bhatt, Deepak L. ; Hernandez, Adrian F. ; Fonarow, Gregg C. / Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction. In: Journal of the American Heart Association. 2013 ; Vol. 2, No. 4.
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abstract = "Hydralazine-isosorbide dinitrate (H-ISDN) therapy is recommended for African American patients with moderate to severe heart failure with reduced ejection fraction (<40{\%}) (HFrEF), but use, temporal trends, and clinical characteristics associated with H-ISDN therapy in clinical practice are unknown. An observational analysis of 54 622 patients admitted with HFrEF and discharged home from 207 hospitals participating in the Get With The Guidelines-Heart Failure registry from April 2008 to March 2012 was conducted to assess prescription, trends, and predictors of use of H-ISDN among eligible patients. Among 11 185 African American patients eligible for H-ISDN therapy, only 2500 (22.4{\%}) received H-ISDN therapy at discharge. In the overall eligible population, 5115 of 43 498 (12.6{\%}) received H-ISDN at discharge. Treatment rates increased over the study period from 16{\%} to 24{\%} among African Americans and from 10{\%} to 13{\%} among the entire HFrEF population. In a multivariable model, factors associated with H-ISDN use among the entire cohort included younger age; male sex; African American/Hispanic ethnicity; and history of diabetes, hypertension, anemia, renal insufficiency, higher systolic blood pressure, and lower heart rate. In African American patients, these factors were similar; in addition, being uninsured was associated with lower use. Overall, few potentially eligible patients with HFrEF are treated with H-ISDN, and among African-Americans fewer than one-fourth of eligible patients received guideline-recommended H-ISDN therapy. Improved ways to facilitate use of H-ISDN therapy in African American patients with HFrEF are needed.",
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AU - Butler, Javed

AU - Yancy, Clyde W.

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