Which ethnic group benefits from a combination of hydralazine and nitrates for reducing mortality in class III or IV heart failure?

The combination of hydralazine and nitrates has been shown to provide significant benefits in reducing mortality in African American patients with class III or IV heart failure. This group has historically demonstrated a better response to this combination therapy compared to other ethnic groups.

Clinical studies, particularly the AHEFT trial, indicated that the combination can lead to improvements in heart failure symptoms, quality of life, and a reduction in mortality rates among African Americans, who often have a higher prevalence of heart failure and a different pathophysiology that might make this therapeutic approach more effective for them.

In contrast, while other ethnic groups also experience heart failure, the literature and clinical guidelines emphasize that the specific mortality benefit from this drug combination is particularly pronounced in the African American population. This highlights the importance of tailoring treatment regimens based on the ethnic and demographic factors that may influence drug effectiveness and outcomes in heart failure management.