Ethnic Disparity in the Clinical Characteristics of Patients with Heart Failure

Israel Gotsman 1 Sarit Avishai-Eliner 2 Refat Jabara 1 Zehava Zemora 2 Ayelet Shauer 1 Chaim Lotan 1 Andre Keren 1
1Heart Institute, Hadassah University Hospital, Jerusalem, Israel
2Clalit Health Services, Jerusalem, Israel

Background: The characteristics of heart failure (HF) patients of different ethnic backgrounds in Israel are unknown. The purpose of the present study was to evaluate the clinical characteristics of Arab versus Jewish patients with chronic heart failure.

Methods: Patients with a diagnosis of HF at a health maintenance organization in Jerusalem, Israel were evaluated. All patients were followed for cardiac related hospitalizations and death.

Results: The study cohort included 6,773 HF patients; 4,991 (74%) were Jewish and 1,735 (26%) were Arab. The overall prevalence of HF in the Jewish versus Arab population was similar (Women: 4.3% versus 4.7% respectively, P=0.06; Men: 5.3% versus 5.2%, P=0.61). The prevalence of HF was significantly higher in Arab subjects of younger age groups (50 to 70 years). Arabs developed heart failure on average 10 years earlier and had a significantly higher rate of diabetes and obesity. Standard of care based on prescribed medications was similar between the ethnic groups. Glucose and cholesterol levels were higher in the Arab cohort. Mortality was similar between the groups at median follow-up (576 days) with the exception of cardiovascular hospitalizations and death that were higher in Arab men.

Conclusions: Arab subjects develop heart failure at a much younger age compared to their Jewish counterparts and have a higher prevalence of diabetes and obesity. Standard of care and clinical outcome are comparable. Implementation of prevention programs to reduce risk factors, particularly diabetes and obesity may help reduce the disparity between Arabs and Jews. 









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