Heart Failure in Non-Caucasians, Women, and Older Adults: A White Paper on Special Populations from the Heart Failure Society of America Guideline Committee

Monica Colvin, Nancy K Sweitzer, Nancy M. Albert, Rajan Krishnamani, Michael W. Rich, Wendy Gattis Stough, Mary Norine Walsh, Cheryl A. Westlake Canary, Larry A. Allen, Mark R. Bonnell, Peter E. Carson, Michael C. Chan, Michael G. Dickinson, Daniel L. Dries, Gregory A. Ewald, James C. Fang, Adrian F. Hernandez, Ray E. Hershberger, Stuart D. Katz, Stephanie MooreJo E. Rodgers, Joseph G. Rogers, Amanda R. Vest, David J. Whellan, Michael M. Givertz

Research output: Contribution to journalArticle

19 Scopus citations


The presentation, natural history, clinical outcomes, and response to therapy in patients with heart failure differ in some ways across populations. Women, older adults, and non-Caucasian racial or ethnic groups compose a substantial proportion of the overall heart failure population, but they have typically been underrepresented in clinical trials. As a result, uncertainty exists about the efficacy of some guideline-directed medical therapies and devices in specific populations, which may result in the under- or overtreatment of these patients. Even when guideline-based treatments are prescribed, socioeconomic, physical, or psychologic factors may affect non-Caucasian and older adult patient groups to a different extent and affect the application, effectiveness, and tolerability of these therapies. Individualized therapy based on tailored biology (genetics, proteomics, metabolomics), socioeconomic and cultural considerations, and individual goals and preferences may be the optimal approach for managing diverse patients. This comprehensive approach to personalized medicine is evolving, but in the interim, the scientific community should continue efforts focused on intensifying research in special populations, prescribing guideline-directed medical therapy unless contraindicated, and implementing evidence-based strategies including patient and family education and multidisciplinary team care in the management of patients.

Original languageEnglish (US)
Pages (from-to)674-693
Number of pages20
JournalJournal of Cardiac Failure
Issue number8
StatePublished - Aug 1 2015



  • African American
  • elderly
  • Heart failure
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Colvin, M., Sweitzer, N. K., Albert, N. M., Krishnamani, R., Rich, M. W., Stough, W. G., Walsh, M. N., Westlake Canary, C. A., Allen, L. A., Bonnell, M. R., Carson, P. E., Chan, M. C., Dickinson, M. G., Dries, D. L., Ewald, G. A., Fang, J. C., Hernandez, A. F., Hershberger, R. E., Katz, S. D., ... Givertz, M. M. (2015). Heart Failure in Non-Caucasians, Women, and Older Adults: A White Paper on Special Populations from the Heart Failure Society of America Guideline Committee. Journal of Cardiac Failure, 21(8), 674-693. https://doi.org/10.1016/j.cardfail.2015.05.013