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A Critical Evaluation of the Representation of Black Patients With Heart Failure and Preserved Ejection Fraction in Clinical Trials: A Literature Review.

Publication ,  Journal Article
Lekavich, CL; Barksdale, DJ
Published in: J Cardiovasc Nurs
2016

BACKGROUND: In the United States, heart failure costs $34.4 billion annually and is associated with a mortality rate of 20% within 5 years of diagnosis. Heart failure preserved ejection fraction (HFpEF) accounts for 50% of all hospital admissions for heart failure. Black patients develop HFpEF at a significantly earlier age than do white patients, and the 5-year mortality rate for blacks with HFpEF is 30% to 44% higher compared with white patients. Current trials may not represent black patients proportionately to the general population. OBJECTIVE: The primary aim of this literature review was to critically evaluate the representation of black patients in HFpEF trials and propose solutions for future research. METHODS: PubMed and CINAHL were queried for peer-reviewed journal articles from 1997 to 2014 using 2 sets of search terms that included HFpEF or preserved left ventricular function and all relevant search terms for black patients. Initially, 182 articles were identified; however, after exclusionary criteria were applied, 22 articles remained. After critical review of each article for relevance, a total of 9 articles remained for the review. RESULTS: For the 9 trials reviewed including a total of 63,065 patients with HFpEF, 10,436 (17%) of the patients were black. Three of the 9 trials included less than 10% black patients, 4 trials included 10% to 20% black patients, and 2 trials included greater than 20% black patients. In 2 studies, the percentage of black patients in the HFpEF trial (13% and 17%) was significantly less than the percentage of black patients in the general regional population (53% and 39%), respectively. DISCUSSION: Although the mortality rate for black patients with HFpEF is 30% to 45% higher than the rate for white patients, 2 of the 9 studies did not have a representative sample of the general HFpEF population and none of the studies reported the objective of establishing a representative study population.

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Published In

J Cardiovasc Nurs

DOI

EISSN

1550-5049

Publication Date

2016

Volume

31

Issue

3

Start / End Page

202 / 208

Location

United States

Related Subject Headings

  • Stroke Volume
  • Patient Selection
  • Nursing
  • Humans
  • Heart Failure
  • Clinical Trials as Topic
  • Black or African American
  • 4205 Nursing
  • 3201 Cardiovascular medicine and haematology
  • 1110 Nursing
 

Citation

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Lekavich, C. L., & Barksdale, D. J. (2016). A Critical Evaluation of the Representation of Black Patients With Heart Failure and Preserved Ejection Fraction in Clinical Trials: A Literature Review. J Cardiovasc Nurs, 31(3), 202–208. https://doi.org/10.1097/JCN.0000000000000237
Lekavich, Carolyn L., and Debra J. Barksdale. “A Critical Evaluation of the Representation of Black Patients With Heart Failure and Preserved Ejection Fraction in Clinical Trials: A Literature Review.J Cardiovasc Nurs 31, no. 3 (2016): 202–8. https://doi.org/10.1097/JCN.0000000000000237.
Lekavich, Carolyn L., and Debra J. Barksdale. “A Critical Evaluation of the Representation of Black Patients With Heart Failure and Preserved Ejection Fraction in Clinical Trials: A Literature Review.J Cardiovasc Nurs, vol. 31, no. 3, 2016, pp. 202–08. Pubmed, doi:10.1097/JCN.0000000000000237.

Published In

J Cardiovasc Nurs

DOI

EISSN

1550-5049

Publication Date

2016

Volume

31

Issue

3

Start / End Page

202 / 208

Location

United States

Related Subject Headings

  • Stroke Volume
  • Patient Selection
  • Nursing
  • Humans
  • Heart Failure
  • Clinical Trials as Topic
  • Black or African American
  • 4205 Nursing
  • 3201 Cardiovascular medicine and haematology
  • 1110 Nursing