NCPA - National Center for Policy Analysis


November 9, 2004

A combination of two rarely used heart drugs cut death rates among black heart-failure patients almost in half, researchers reported Monday. The study of 1,050 patients was published by the New England Journal of Medicine and simultaneously reported at a heart association meeting held in New Orleans.

Heart failure is a progressive breakdown of heart muscle that enlarges the heart, thinning its walls and sapping its pumping power. Researchers found:

  • A specific 43 percent increase in survival, a 33 percent reduction in first hospitalizations and a very significant improvement in quality of life.
  • The results were so convincing that the study was stopped abruptly in July so that the 532 patients who were getting the placebo could join the 518 who were getting the drug.
  • Doctors said widespread use by the 375,000 blacks with moderate to severe heart failure could save as many as 15,000 lives a year -- and also might help people of other races and ethnic backgrounds.

The so-called African-American Heart Failure Trial provoked controversy because it was designed exclusively for blacks, who are more likely to suffer heart failure and die of it than white Americans.

"Are we moving into a new era of race-based therapeutics?" asked M. Gregg Bloche of Georgetown University Law Center in a perspective in the same issue of the journal. The answer, he says, may be yes, and it may be justified by genetic and other differences between populations.

Source: Anne L. Taylor et al., "Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure," New England Journal of Medicine, November 8, 2004; and Steve Sternberg, "Drugs cut heart failure deaths; Blacks' death rate falls 43% in study," USA Today, November 9, 2004.


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