Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment
ObjectiveTo evaluate the effect of different pharmacological therapies for heart failure (HF) between the Black vs. White population.MethodWe included randomized controlled trials (RCT) of HF pharmacological therapies with explicit strata of Black or White adults in the primary or secondary analysis...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1482311/full |
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| author | Yujia Li Huilin Tang Wenxi Huang Wei-Han Chen Shao-Hsuan Chang Jiang Bian Mustafa M. Ahmed Stephen E. Kimmel Jingchuan Guo |
| author_facet | Yujia Li Huilin Tang Wenxi Huang Wei-Han Chen Shao-Hsuan Chang Jiang Bian Mustafa M. Ahmed Stephen E. Kimmel Jingchuan Guo |
| author_sort | Yujia Li |
| collection | DOAJ |
| description | ObjectiveTo evaluate the effect of different pharmacological therapies for heart failure (HF) between the Black vs. White population.MethodWe included randomized controlled trials (RCT) of HF pharmacological therapies with explicit strata of Black or White adults in the primary or secondary analysis. We examined three outcomes: (1) the composite of CV death or hospitalization for heart failure (HHF), (2) HHF, and (3) all-cause death. Within each race (White and Black), we calculated the pooled risk ratio (RR) with a 95% confidence interval (CI) of different pharmacological therapies using random-effects models. Within each pharmacological therapies, we assess the differences in the treatment effect by race.ResultsIn 19 RCT reporting eight pharmacological therapies, there was no significant difference between the Black and White groups for using sacubitril/valsartan, angiotensin-converting enzyme inhibitors, calcium-channel blockers, direct renin inhibitors, oral soluble guanylate cyclase, or vasodilators. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) had a different effect in HHF across the White and Black patients (Pinteraction = .030), with a better treatment effect observed in the Black (RR 0.39, 95% CI 0.19–0.80) compared to the White group (0.90, 0.71–1.14). Beta-blockers had a better treatment effect in the White (0.65, 0.52–0.81) compared to the Black group (1.14, 0.88–1.47) regarding the all-cause death outcome (Pinteraction = .001).ConclusionBlack individuals with HF appeared to obtain a greater benefit of HHF risk reduction from SGLT2i and less benefit for mortality from beta-blockers compared to their White counterparts. |
| format | Article |
| id | doaj-art-833caf899dfa4055bc64d6f8e79ac790 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-833caf899dfa4055bc64d6f8e79ac7902025-08-20T03:27:36ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.14823111482311Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatmentYujia Li0Huilin Tang1Wenxi Huang2Wei-Han Chen3Shao-Hsuan Chang4Jiang Bian5Mustafa M. Ahmed6Stephen E. Kimmel7Jingchuan Guo8Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesDepartment of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesDepartment of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL, United StatesDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United StatesObjectiveTo evaluate the effect of different pharmacological therapies for heart failure (HF) between the Black vs. White population.MethodWe included randomized controlled trials (RCT) of HF pharmacological therapies with explicit strata of Black or White adults in the primary or secondary analysis. We examined three outcomes: (1) the composite of CV death or hospitalization for heart failure (HHF), (2) HHF, and (3) all-cause death. Within each race (White and Black), we calculated the pooled risk ratio (RR) with a 95% confidence interval (CI) of different pharmacological therapies using random-effects models. Within each pharmacological therapies, we assess the differences in the treatment effect by race.ResultsIn 19 RCT reporting eight pharmacological therapies, there was no significant difference between the Black and White groups for using sacubitril/valsartan, angiotensin-converting enzyme inhibitors, calcium-channel blockers, direct renin inhibitors, oral soluble guanylate cyclase, or vasodilators. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) had a different effect in HHF across the White and Black patients (Pinteraction = .030), with a better treatment effect observed in the Black (RR 0.39, 95% CI 0.19–0.80) compared to the White group (0.90, 0.71–1.14). Beta-blockers had a better treatment effect in the White (0.65, 0.52–0.81) compared to the Black group (1.14, 0.88–1.47) regarding the all-cause death outcome (Pinteraction = .001).ConclusionBlack individuals with HF appeared to obtain a greater benefit of HHF risk reduction from SGLT2i and less benefit for mortality from beta-blockers compared to their White counterparts.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1482311/fullmeta-analysisheart failuretreatment outcomeracial differenceSGLT2 inhibitors |
| spellingShingle | Yujia Li Huilin Tang Wenxi Huang Wei-Han Chen Shao-Hsuan Chang Jiang Bian Mustafa M. Ahmed Stephen E. Kimmel Jingchuan Guo Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment Frontiers in Cardiovascular Medicine meta-analysis heart failure treatment outcome racial difference SGLT2 inhibitors |
| title | Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment |
| title_full | Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment |
| title_fullStr | Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment |
| title_full_unstemmed | Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment |
| title_short | Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment |
| title_sort | clinical outcomes of pharmacological therapies for heart failure in black vs white populations a meta analysis of randomized controlled trials of heart failure treatment |
| topic | meta-analysis heart failure treatment outcome racial difference SGLT2 inhibitors |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1482311/full |
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