NIH-supported study finds racial disparities in advanced heart failure treatment
Black adults treated at advanced heart failure centers received potentially life-changing therapies, such as transplants and heart pumps, about half as often as white adults, possibly due to racial bias, a small National Institutes of Health-supported study has found. Researchers followed 377 patients receiving treatment at one of 21 centers in the United States and found that 62 of 277 white adults (22%) received a heart transplant or ventricular assist device (VAD), a mechanical device that pumps blood for the heart. In comparison, 11 of 100 Black adults (11%) received these end-stage heart failure therapies, which can extend and improve a patient’s quality of life.
The researchers said the findings, which appear in Circulation: Heart Failure, underscore the importance in strengthening equity in clinical decision-making for the 600,000 Americans – particularly Black adults – who have end-stage heart failure. Prior studies have shown Black adults have a greater risk for heart failure and are twice as likely to die from it.
The findings are from the Registry Evaluation of Vital Information for VADs in Ambulatory Life (REVIVAL), an observational two-year study supported by NHLBI to better understand the course of heart failure. This part of the study expands on previous research analyzing disparities in advanced heart failure treatment.
For their analysis, the researchers controlled for multiple factors, including disease severity, quality of life, and several social determinants of health, or conditions within the environment where people live that affect health outcomes. They did not find associations between the patients’ race and death rates. Eighteen Black adults (18%) and 36 white adults (13%) died during the study. Importantly, they found that treatment preferences between the two groups were similar. Yet, being Black was associated with a 55% reduced rate for receiving VAD therapy or a heart transplant.
