Worsening Heart Failure | Episode Four

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Host:

• Robert Underwood, MD

Guest:

• Erin D. Michos, MD, MHS
  • Director of Women’s Cardiovascular Health Research
  • Associate Director of Preventive Cardiology at Johns Hopkins University
  • Co-Director of the IMPACT Center at Johns Hopkins University
  • Co-Editor-in-Chief of the American Journal of Preventive Cardiology

Supported by:

• Independent educational grant from Merck, Sharp, and Dohme

Episode Overview:
In the final episode of this four-part series, Dr. Robert Underwood and Dr. Erin Michos explore health disparities in the diagnosis and treatment of heart failure, particularly in minority racial/ethnic groups and female patients. They discuss the influence of social determinants of health and highlight evidence-based strategies to reduce these disparities and improve outcomes for all patients.

Key Takeaways:

• Health Disparities in Heart Failure:
  • Black and Hispanic populations are at greater risk for heart failure due to higher rates of comorbidities like obesity, hypertension, and diabetes, as well as social determinants of health.
  • Black adults are 200% more likely to be hospitalized for heart failure than white adults, with higher heart failure mortality rates among Black men and women.
• Gender Differences in Heart Failure:
  • Women are more likely to develop heart failure with preserved ejection fraction (HFpEF) and may experience more pronounced symptoms, but they are less likely to undergo diagnostic testing or receive advanced treatments like heart transplants or mechanical circulatory devices.
• Reducing Disparities:
  • Early recognition of heart failure symptoms and the use of diagnostic tools like echocardiograms and BNP levels can help improve diagnosis in minority and female patients.
  • Community-based approaches, such as involving barbershops and faith-based organizations in underserved areas, are innovative strategies to improve cardiovascular health and reduce disparities.
• Case Study:
  • The discussion concludes with a case study involving a 60-year-old Hispanic woman with HFpEF and hypertension. Treatment considerations include the use of diuretics, SGLT2 inhibitors, ARNIs, and lifestyle modifications to address her heart failure and comorbidities.

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