Researchers have confirmed a common cause of heart failure in African-Caribbean patients, thanks to funding from the British Heart Foundation (BHF). The lead researcher, Dr Jason Dungu, says their findings suggest that doctors should be taking ethnicity into consideration when making decisions about diagnosis and treatment of heart failure.
The study, published in the journal Circulation Heart Failure, looked at almost 1,400 patients with heart failure in St George's Hospital heart failure clinic over seven years. Of these, 211 were African-Caribbean.
The researchers found that coronary heart disease, the most common cause of heart failure in white patients (41%), was the cause of heart failure in only 13% of African-Caribbean patients.
On the other hand, the study discovered that a rare condition called cardiac amyloidosis is the fourth most common cause of heart failure in people of African-Caribbean descent, accounting for more than 11 per cent of heart failure cases in patients over the age of 65. This is compared to only 1.6 per cent in white patients.
Amyloidosis is a condition in which abnormal deposits of a protein, called amyloid, build up. This can take place in the heart, a disorder known as cardiac amyloidosis, which makes it difficult for the heart to pump blood effectively around the body.
The team also found that the chance of survival in patients with heart failure due to cardiac amyloidosis is poorer than it is in people who develop heart failure as a result of coronary heart disease, suggesting that those with amyloidosis should have closer follow-up.
Dr Jason Dungu, the lead researcher on the BHF-funded study at St George's, University of London, said:
"We know that causes of heart disease vary a lot between patients of different ethnicities. Coronary heart disease is the leading cause of heart failure in the general population, but accounts for a small number of heart failure cases in African-Caribbean populations, who were previously thought to have heart failure as a result of high blood pressure.
"It is not enough to just be aware of these differences, as they can have an important impact on both the diagnosis and treatment of conditions like heart failure. For example, amyloidosis can be detected by an MRI scan, whereas coronary heart disease is more commonly diagnosed with an invasive test known as angiography, which is unable to detect amyloidosis.
"This research highlights the importance of tailoring cardiac investigations and treatment to the patient, according to age, gender and ethnicity, ensuring that a personalised approach is used in different patient populations."
Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, which funded the study, said:
"Heart failure is a debilitating condition which can occur due to a variety of reasons, of which heart attacks are the most common in the general population. However it is important to appreciate the underlying cause of heart failure in any individual, so that treatments can be tailored to the patient.
"This important study represents another step forward in our understanding of the different causes of heart failure in ethnic minorities.
"With the support and generosity of the public, the British Heart Foundation is also funding over £1 million pounds of research looking at genetics to find out whether people's genetic ancestry can be used to identify the best treatment for high blood pressure, which is a major cause of heart failure in African-Caribbean patients."
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