Heart Failure Management in African Americans: Meeting the Challenge

Endothelial dysfunction in African-Americans

The journey of atherosclerosis begins with endothelial dysfunction and culminates into its most fearful destination producing ischemia, myocardial infarction and death. The excess cardiovascular disease morbidity and mortality in African-Americans is one of the major public health problems. In this review, we discuss vascular endothelial dysfunction as a key element for excess cardiovascular disease burden in this target population. It can be logical window of future atherosclerotic outcomes, and further efforts should be made to detect it at the earliest in African American individuals even if they are appearing healthy as the therapeutic interventions if instituted early, might prevent the subsequent cardiac events.

Executive summary of the African-American Initiative

The roundtable discussion, "Managing Cardiovascular Disease in African Americans: Emerging Strategies for Optimizing Care, " was convened to review the evidence that supports best practices for the management of cardiovascular disease and its complications in African Americans. Treatment guidelines are reviewed, as is the clinical evidence supporting the use of diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta-blockers. The ultimate goals of this work are to improve the understanding of the links among hypertension, diabetes, the metabolic syndrome, and cardiovascular disease, all of which disproportionately affect African Americans, and to increase physician awareness of the unique impact of these conditions in the often underserved African-American population.