Treatment of Heart Failure with Reduced Ejection Fraction in Self-Identified African American Patients with NYHA Class III–IV Symptoms

This protocol applies to a specific sub-population: patients who self-identify as African American with heart failure with reduced ejection fraction (LVEF ≤40%), presenting with advanced NYHA class III to IV symptoms, and who are already receiving optimal medical therapy.

Clinical Scenario

In self-identified African American patients with NYHA class III–IV HFrEF (LVEF ≤40%) on optimal medical therapy, standard guideline-directed care may not be sufficient. Evidence identifies this population as one in whom additional targeted pharmacological intervention is specifically supported to improve symptoms and reduce morbidity and mortality.

Treatment Approach — Partial Overview

Current evidence supports the addition of a specific fixed-dose vasodilator combination to ongoing optimal medical therapy in this population. The complete structured regimen — including sequencing, monitoring, and decision points — is available via the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1161/CIR.0000000000001063

For patients self-identified as African American with NYHA class III-IV HFrEF who are receiving optimal medical therapy, the combination of hydralazine and isosorbide dinitrate is recommended to improve symptoms and reduce morbidity and mortality.

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