June 29, 2026Journal of the American College of Cardiology89 citations
View Full PaperRace and Ethnicity in Heart Failure
Key Result
Heart failure affects >6 million Americans, with Black adults having the highest risk of onset, hospitalization, and death, driven by clinical factors, social determinants, and structural racism.
Key Points
- This review aims to analyze how race and ethnicity influence heart failure risk and outcomes, focusing on social determinants.
- Reviewed clinical and physiological data on heart failure incidence and outcomes by race/ethnicity.
- Examined the role of socioeconomic and social determinants of health in heart failure risks.
- Identified elements of structural racism and implicit bias contributing to health care disparities.
- Black adults show the highest risk for heart failure with significant mortality and hospitalization rates.
- Hispanic patients have a higher rate of hospitalizations compared to White patients.
- Structural factors such as socioeconomic status significantly worsen outcomes for racial/ethnic minority groups.
Structured PICO
P
Population
Americans with or at risk for heart failure, with a focus on racial and ethnic minorities (Black, Hispanic, Asian).
This review highlights the significant racial and ethnic disparities in heart failure incidence and outcomes in the US, emphasizing the role of social determinants of health and structural racism.
Abstract
Heart failure (HF) affects >6 million Americans, with variations in incidence, prevalence, and clinical outcomes by race/ethnicity. Black adults have the highest risk for HF, with earlier age of onset and the highest risk of death and hospitalizations. The risk of hospitalizations for Hispanic patients is higher than White patients. Data on HF in Asian individuals are more limited. However, the higher burden of traditional cardiovascular risk factors, particularly among South Asian adults, is associated with increased risk of HF. The role of environmental, socioeconomic, and other social determinants of health, more likely for Black and Hispanic patients, are increasingly recognized as independent risk factors for HF and worse outcomes. Structural racism and implicit bias are drivers of health care disparities in the United States. This paper will review the clinical, physiological, and social determinants of HF risk, unique for race/ethnic minorities, and offer solutions to address systems of inequality that need to be recognized and dismantled/eradicated.