An antecedent body of work established nearly 20 years ago benchmarked the nuanced distinctions of heart failure affecting African American people. Summative statements established a nearly 2-fold higher incidence, earlier onset, greater severity at the time of diagnosis, a more likely nonischemic etiology, a putative pathophysiology attributed to hypertensive heart disease, greater morbidity, and in younger ages (45-64 years) higher mortality. The coincident burden of adverse social determinants of health further delineates the disproportionate burden of heart failure in African American individuals. Given that race is a social construct, this peculiar predilection for a nonischemic heart failure phenotype requires further investigation.
