Further Study Needed to Evaluate Influence of Racial
Disparity on Patient Outcomes
NEW ORLEANS, Nov. 8 /PRNewswire/ -- Data presented today from the world's
largest heart failure registry known as ADHERE(R) (Acute Decompensated Heart
Failure National Registry) indicate that Hispanic Americans may have higher
rates of diabetes and higher cholesterol levels than African American and
Caucasian patients who are admitted to the hospital for heart failure. These
data were presented at the American Heart Association (AHA) Scientific
Sessions 2004 in New Orleans.
"For the first time we have data that clearly show there may be
differences in how Hispanic Americans present with heart failure compared to
other ethnic groups," said Javier Jimenez, M.D., Assistant Professor of
Medicine at the University of Miami/Jackson Memorial Medical Center in Miami,
Fla., and lead author of the study. "We need to understand how genetic and
cultural differences play a part in patient care if we are to improve heart
failure patient treatment and outcomes."
The new ADHERE(R) observational analysis provides a first-time glimpse of
how the hospital treatment, outcomes and presenting clinical characteristics
of Hispanic Americans may differ from those of African American and Caucasian
heart failure patients. The study evaluated patients from the three ethnic
groups who were admitted to ADHERE(R)-participating hospitals between October
2001 and February 2003 and who were diagnosed with acutely decompensated
congestive heart failure.
According to the ADHERE(R) observational analysis, Hispanic Americans more
often were male and had a higher incidence of diabetes and high cholesterol
than African American or Caucasian heart failure patient cases in the study.
"It is important to act now to identify the gaps in heart failure care and
outcomes among different ethnic groups, otherwise we risk allowing these gaps
to widen rather than be eliminated," said Clyde W. Yancy, M.D., Professor of
Medicine & Cardiology, Director of Congestive Heart Failure/Heart Transplant
Program at University of Texas Southwestern Medical Center, Dallas, and
supporting author of the study. "Currently, the ADHERE(R) database indicates
that Hispanic Americans constitute no more than 3% of the overall population
affected with heart failure, but given the high penetration of cardiovascular
risk factors and the growing Hispanic American population, the problem of
heart failure is likely to grow in this group. ADHERE(R) offers us the
opportunity to determine the gaps in heart failure care that influence how
patients present and are treated with the disease, and how to close them."
A previous analysis of the observational data from ADHERE(R) showed that
there is significant variation in the in-hospital care afforded to acute heart
failure patients nationwide. According to the study presented during the AHA
Scientific Sessions 2003, less than one-third of patients hospitalized with
heart failure are provided with educational counseling and guideline-
recommended angiotensin-converting-enzyme inhibitors (blood pressure-lowering
medications) prior to discharge.
The National Institutes of Health characterizes congestive heart failure
(CHF) as an epidemic affecting nearly 5 million Americans, and it is the most
common discharge diagnosis in hospital patients age 65 and older.(1) According
to the U.S. Department of Health and Human Services, the number of Americans
older than age 65 is expected to increase by nearly one-third during the next
two decades, with proportions of minorities in the overall population
increasing from 11.4% to 16.3% for Hispanic Americans and 12.9% to 14.0% for
African Americans. At its current rate, the population of heart disease
survivors is expected to grow at a much faster rate than the U.S. population
as a whole.(2)
About the ADHERE(R) Study
The observational analysis, titled "Clinical characteristics and outcomes
of Hispanic Americans admitted with acute decompensated heart failure: An
Analysis from a large prospective registry database" (04-SS-A-9941-AHA), was
presented by Javier Jimenez, M.D. and evaluated clinical characteristics and
in-hospital outcomes from ADHERE(R) Registry data on 61,778 patients
hospitalized with acute decompensated heart failure. Patients were divided
into three categories: Hispanic Americans (HA, 1,662 patients), African
Americans (AA, 12,914) and Caucasians (C, 47,202), and clinical
characteristics and in-hospital outcomes between the three groups were
compared.
The ADHERE(R) analysis found that Hispanic Americans with heart failure
were 10% more likely than African Americans and 15% more likely than
Caucasians to have diabetes (p<.0001). The study also found that Hispanic
Americans were 5% more likely than African Americans and 3% more likely than
Caucasians to be males (p<.0001). In addition, the study found that Hispanic
Americans were 11% more likely than African Americans and 1% more likely than
Caucasians to and have hyperlipidemia, or high amounts of lipids and
cholesterol in the bloodstream (p<.0001).
In terms of age, tobacco abuse, renal insufficiency and ischemic
cardiomyopathy, or congestive heart failure resulting from coronary artery
disease, the score for HA patients was intermediate between AA and C heart
failure patients. Data on HA patients was also intermediate between AA and C
patients in terms of in-hospital mortality and total length of stay in
hospital intensive care units due to complications from congestive heart
failure.
About ADHERE(R)
The ADHERE(R) Registry is a first-of-its-kind national registry that
collects observational data from across the U.S. in order to track and study
the medical management of patients hospitalized with acute heart failure.
ADHERE(R) is designed to help the medical community better understand acute
CHF, improve its management and enhance quality of care. The ADHERE(R)
National Registry is sponsored by Scios Inc. and overseen by an independent
scientific advisory committee of nationally recognized heart failure experts.
To learn more about The ADHERE(R) Registry, call 1-866-616-2993, or e-mail
adhereinfo@sciosinc.com, or visit http://www.adhereregistry.com.
About Congestive Heart Failure
According to the American Heart Association Heart Disease and Stroke
Statistics -- 2004 Update, at age 40 the lifetime risk of developing heart
failure is 1 in 5, and it is estimated that the cost of treating congestive
heart failure patients in the U.S. will reach $28.8 billion in 2004.
Congestive heart failure is characterized by a progressive loss in the heart's
ability to pump blood. Since a weak heart does not pump fluid very well
through the body, fluid can back up and "pool" in the lungs causing shortness
of breath or can accumulate in the ankles causing swelling. This is why heart
failure is often called "congestive" heart failure, or CHF. The term
"decompensated" is a medical term used to describe patients with these
symptoms.
About Scios Inc.
Scios Inc., a Johnson & Johnson company, is a biopharmaceutical company
headquartered in Fremont, California. Scios is developing novel treatments for
cardiovascular disease, inflammatory disease and cancer. The Company's
disease-based technology platform integrates expertise in protein biology with
computational and medicinal chemistry to identify novel targets and rationally
design small molecule compounds and peptides for markets with unmet medical
needs. For more information, visit http://www.sciosinc.com.
(1) National Institutes of Health, National Heart, Lung, and Blood
Institute, Data Fact Sheet, Congestive Heart Failure in the United
States: A New Epidemic, September 1996.
(2) The U.S. Department of Health and Human Services Centers for Disease
Control and Prevention, A Public Health Action Plan to Prevent Heart
Disease and Stroke, http://www.cdc.gov/cvh/Action_Plan/ , last updated
July 2003.
SOURCE Scios Inc.
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Related links:
http://www.sciosinc.com
CONTACT:
Chris L. Ernst of Scios Inc.,
+1-415-710-9445; or Karin Bauer Aranaz of WeissComm Partners,
Inc., +1-415-859-3414, for Scios Inc.
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