Lupine Publishers-Open access journal of Cardiovascular

Understanding the Demographic and Clinical Characteristics of Heart Failure to Improve Management Practices: The Caribbean Perspective by Felix Nunura in ACR in Lupine Publishers.

There is no doubt that Heart Failure is a complex syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood [1], moreover, Heart Failure is a disease in which there are striking population differences in almost every aspect of the disease. It has been recognized that the cause of Heart Failure is predominantly ischemic disease in nonblack but is related primarily to Hypertension in Blacks [2], accordingly, this statements should be confirmed in Afro-Caribbean patients because population differences exist that may be attributable to differences in social factors, genetics, environment , lifestyle, comorbidities, and complex interactions among this factors [3].

Heart failure research data in African American: can also them be applied in afro Caribbean patients?

The majority of the data on Heart Failure in African descendant has been done in African American population and that research should be validated in the Caribbean Region. The U.S. Office of Management and Budget [4] defines “Black” of “African American” as having origins in any of the Black racial groups of Africa. The term African Caribbean/Afro-Caribbean when used in Europe usually refers to people with African ancestral origins who migrated via the Caribbean islands [5]. The majority of Jamaicans (92.1%) identify as black [6] however there are other ethnic groups [7]: Mixed (6.1%), Asian (0.8%), others (0.4%). Much of Jamaica’s black population is of African or partially African descent with many being able to trace their origins to West Africa and the term African Caribbean must be restricted to an African descent person originating from the Caribbean. Although it seems reasonable to think in terms of African Descendant Data the Heart Failure clinical studies in African American should be validated in the Caribbean Region.

Disparities Between White and Black: Studies In African American Population

Recent research continues suggesting disparities between white and black populations: In a Random Cohort of 2,188 participants from The Reasons for Geographic and Racial Differences in Stroke Project - REGARDS-[8] without prevalent cardiovascular disease studied by race was showed that Plasma N-terminal pro b-type natriuretic peptide (NTproBNP ) levels are significantly lower in blacks as compared to whites however the contribution of endogenous suppression of Natriuretic Peptide system on cardiovascular disease in blacks remains to be established On the other hand , in relation with the etiology of patients with Heart Failure, when defined as a prior documented myocardial infarction or known epicardial coronary artery disease, ischemic heart disease appears to be present in just 35% of African- American patients and the exact mix of hypertensive heart disease and idiopathic dilated cardiomyopathy (as well as the influence of alcoholic cardiomyopathy) is not discernible from published data.

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