Browsing by Author "Free, Kendall"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Heart Failure with Reduced Ejection Fraction and COVID-19, when the Sick Get Sicker: Unmasking Racial and Ethnic Inequities During a Pandemic
    (Elsevier, 2023) Contreras, Johanna; Tinuoye, Elizabeth O.; Folch, Alejandro; Aguilar, Jose; Free, Kendall; Ilonze, Onyedika; Mazimba, Sula; Rao, Roopa; Breathett, Khadijah; Medicine, School of Medicine
    Minoritized racial and ethnic groups have the highest incidence, prevalence, and hospitalization rate for heart failure. Despite improvement in medical therapies and overall survival, the morbidity and mortality of these groups remain elevated. The reasons for this disparity are multifactorial, including social determinant of health (SDOH) such as access to care, bias and structural racism. These same factors contributed to higher rates of COVID-19 infection among minoritized racial and ethnic groups. In this review, we aim to explore the lessons learned from the COVID 19 pandemic and its interconnection between heart failure and SDOH. The pandemic presents a window of opportunity for achieving greater equity in the health care of all vulnerable populations.
  • Thumbnail Image
    Item
    Racial, Ethnic, and Gender Disparities in Valvular Heart Failure Management
    (Elsevier, 2023) Ilonze, Onyedika; Free, Kendall; Shinnerl, Alexander; Lewsey, Sabra; Breathett, Khadijah; Medicine, School of Medicine
    Racial, ethnic, and gender disparities are present in the diagnosis and management of valvular heart disease. The prevalence of valvular heart disease varies by race, ethnicity, and gender, but diagnostic evaluations are not equitable across the groups, which makes the true prevalence less clear. The delivery of evidence-based treatments for valvular heart disease is not equitable. This article focuses on the epidemiology of valvular heart diseases associated with heart failure and the related disparities in treatment, with a focus on how to improve delivery of nonpharmacological and pharmacological treatments.
  • Thumbnail Image
    Item
    Unequitable Heart Failure Therapy for Black, Hispanic and American-Indian Patients
    (Radcliffe Medical Media, 2022-07-07) Ilonze, Onyedika; Free, Kendall; Breathett, Khadijah; Medicine, School of Medicine
    Despite the high prevalence of heart failure among Black and Hispanic populations, patients of colour are frequently under-prescribed guideline-directed medical therapy (GDMT) and American-Indian populations are not well characterised. Clinical inertia, financial toxicity, underrepresentation in trials, non-trustworthy medical systems, bias and structural racism are contributing factors. There is an urgent need to develop evidence-based strategies to increase the uptake of GDMT for heart failure in patients of colour. Postulated strategies include prescribing all GDMT upon first encounter, aggressive outpatient uptitration of GDMT, intervening upon social determinants of health, addressing bias and racism through changing processes or policies that unfairly disadvantage patients of colour, engagement of stakeholders and implementation of national quality improvement programmes.