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The characteristics of heart failure (HF) patients of different ethnic backgrounds in Israel are unknown. The purpose of the present study was to evaluate the clinical characteristics of Arab vs. Jewish patients with chronic HF.Patients with a diagnosis of HF at a health maintenance organization in Jerusalem, Israel were evaluated. All patients were followed for cardiac-related hospitalizations and death. The study cohort included 6773 HF patients; 4991 (74%) were Jewish and 1735 (26%) were Arab. The overall prevalence of HF in the Jewish vs. Arab population was similar (women, 4.3% vs. 4.7%, respectively, P = 0.06; men, 5.3% vs. 5.2%, P = 0.61). The prevalence of HF was significantly higher in Arab subjects of younger age groups (50–70 years). Arabs developed HF on average 10 years earlier and had a significantly higher rate of diabetes and obesity. Standard of care based on prescribed medications was similar between the ethnic groups. Glucose and cholesterol levels were higher in the Arab cohort. Mortality was similar between the groups at median follow-up (576 days), with the exception of cardiovascular hospitalizations and death that were higher in Arab men.Arab subjects develop HF at a much younger age compared with their Jewish counterparts and have a higher prevalence of diabetes and obesity. Standard of care and clinical outcome are comparable. Implementation of prevention programmes to reduce risk factors, particularly diabetes and obesity, may help reduce the disparity between Arabs and Jews.