A Review of Disparities in Care for Heart Failure

Heart failure affects 5.7 million people in the United States, with the incidence approaching 10 per 1000 after 65 years. The reduced incidence of heart failure with reduced ejection fraction (HFrEF) is attributable to the use of guideline-directed medical therapy (GDMT), cardiac resynchronization therapy (CRT), implantable cardioverter defibrillator (ICDs), left ventricular assist devices (LVAD) and cardiac transplant, used based on patients' eligibility. Despite these advances, there is still only a 50% five-year survival rate in heart failure (HF). These drawbacks in milestones already achieved in the management of heart failure are because of complex factors including disparities in care. Racial, socioeconomic, gender, geographic disparities in medications and use of cardiac devices and mechanical circulatory support have been described in several studies and have been shown to lead to adverse health outcomes in heart failure patients.