Racial differences in heart failure therapeutics.

Heart failure in African Americans has a phenotype that is distinct from that in non-African Americans and that demonstrates increased importance of hypertensive etiologies. Trial data demonstrate that African Americans receive significant benefit from beta blockade. Despite differences in the heart failure phenotype, therapy of heart failure in African Americans remains largely the same as in white heart failure cohorts, with the notable exception of the added benefits provided by combination of hydralazine and isosorbide dinitrate (HYD-ISDN), now regarded as highly indicated therapy by both the Heart Failure Society of America and the American College of Cardiology/American Heart Association heart failure guideline committees. HYD-ISDN in fixed combination is the first cardiovascular drug approved for a single ethnic or racial subset--self-designated African Americans.