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July 21, 2020

Health Disparities in Advanced Heart Failure Treatment: The Intersection of Race and Sex

Author Affiliations
  • 1Division of Nephrology, Department of Medicine, University of Washington, Seattle
  • 2Hospital and Specialty Medicine and Seattle Health Services Research and Development Center of Innovation for Veteran-Centered and Veteran-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
JAMA Netw Open. 2020;3(7):e2011034. doi:10.1001/jamanetworkopen.2020.11034

Heart failure is a costly, morbid condition that is estimated to affect approximately 6.2 million individuals in the United States at a cost of $30.7 billion, which is estimated to increase to $69.8 billion by 2030.1 African American individuals are disproportionately diagnosed with heart failure compared with white individuals. Overall, the incidence typically starts several decades earlier2 and is associated with greater morbidity and mortality in African American than white individuals.1 African American men have the highest age-adjusted death rate for heart failure (118.2 per 100 000), followed by non-Hispanic white men (111.3 per 100 000), African American women (86.0 per 100 000), and white women (80.4 per 100 000).1 After medical management is no longer effective, advanced therapies for heart failure, such as ventricular assist devices (VAD), improve quality of life and survival and can be used as terminal treatment or as a bridge to heart transplantation.1

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