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CMHC PULSE

Cardio Metabolic Health Congress – Official Blog

Proposed Quality Measure Will Ensure African Americans with Heart Failure Receive the Standard of Care

A new quality measure has been submitted for consideration by the National Minority Quality Forum (NMQF) to the National Quality Forum (NQF), that if approved, will help ensure that African Americans living with heart failure (HF) will not die prematurely because they are not receiving the standard of care. Public comment began on July 23 and members of the general public are encouraged to support the proposal and comment by August 12 via the NQF’s webpage.

This past March, Dr. Keith C. Ferdinand spoke on the prevalence and severity of HF in African Americans at the Best of the CMHC Regional Conference Series.

“The harsh reality is that African Americans suffer from earlier onset and more prevalent and severe heart failure, with higher readmissions,” Dr. Ferdinand said. “These real and unfortunate disparities demand the appropriate application of evidence-based, guideline-supported pharmacotherapy in blacks. Clinicians, public health leaders, and policymakers cannot overlook this necessary responsibility to ensure the best therapy for all patients where indicated.” Plan on attending the 10th Annual CMHC Boston, October 21-24, 2015 to hear more perspective on the topic.

The new quality measure is fully supported by the Association of Black Cardiologists as well as ACC/AHA guidelines and emphasizes the importance of adherence to the current standard of care for African Americans with HF. More than 550,000 African Americans are living with HF, of whom more than 150,000 should be prescribed fixed-dose hydralazine and isosorbide dinitrate, a drug regimen proven to reduce mortality in African Americans by 43% and first-time hospitalizations for HF by 33%.

Few, however, are actually receiving this regimen. According to Dr. Gary Puckrein, CEO of the NMQF and the proposed measure’s steward, “Astonishingly, only a very small portion, about 7%, of African Americans who are clinically eligible for the therapy are getting it.”

View Dr. Keith Ferdinand’s One-Minute Clinician video interview for more insight.

New Treatment for Hyperkalemia Shows Promise

Hyperkalemia is a serious clinical challenge in patients with chronic cardiometabolic diseases and comorbidities, and there is currently a large unmet need for better treatments. A study just published in JAMA has shown that patients suffering from hyperkalemia and diabetic kidney disease showed significant decreases in serum potassium levels when treated with patiromer, a new drug by Relypsa Inc. awaiting FDA approval later this year. (Only one FDA-approved treatment option for hyperkalemia currently exists.) These decreases in potassium were evident after only 4 weeks of treatment, and, importantly, lasted 52 weeks afterward. Dr. George L. Bakris, a professor of medicine at the University of Chicago who led the study, will be chairing the 10th Annual Cardiometabolic Health Congress sessions and the CME symposium, “New Insights into the Prevention and Clinical Management of Hyperkalemia,” being held in Boston October 21-24, 2015. Hyperkalemia, characterized by dangerously high potassium levels, is potentially life threatening and most often seen in patients treated with RAAS inhibitors who have stage 3 or greater chronic kidney disease who may also have diabetes, heart failure, or both.

Advances in Heart Failure
Also of note, the first of a new class of drugs known as angiotensin receptor neprolysin inhibitors (ARNIs) has received FDA approval for patients with heart failure after showing a significant mortality benefit compared with an ACE inhibitor. Dr. Clyde W. Yancy will be speaking about this eagerly awaited new option and other novel HF therapies at the 10th Annual CMHC, joining an expert panel on Friday, October 23.

Reference: Bakris GL, et al. Effect of patiromer on serum potassium level in patients with hyperkalemia and diabetic kidney disease. The AMETHYST-DN Randomized Clinical Trial. JAMA. 2015;314:151-161.