This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Traits Among Urban Blacks

Jalal K. Ghali, MD; Sunil Kadakia, MD; Richard Cooper, MD; Jack Ferlinz, MD

Arch Intern Med. 1988;148(9):2013-2016.

Abstract
• Potential precipitating factors that led to cardiac decompensation and subsequent hospital admission for heart failure were examined in 101 patients in a large public hospital serving a predominantly working-class minority population. Ninety-seven percent of patients were black; their age was 59± 14 years (mean ±SD); on average, they were hospitalized three times in the preceding year for problems related to their heart failure. Potential precipitating factors for decompensated heart failure were identified in 93% of patients. Lack of adherence to the prescribed medical regimen was the most commonly identified causative factor and was noted in 64% of the cases; noncompliance with diet amounted to 22%, with drugs to 6%, and with the combination of drugs and diet to 37%. Other factors also related to hospitalization were cardiac arrhythmias (29%), emotional/environmental issues (26%), inadequately conceived drug therapy (17%), pulmonary infections (12%), and thyrotoxicosis (1%). Thus, the key preventive measure necessary in at least two thirds of patients centered around better adherence to drug and/or diet regimen, highlighting the precept that better patient education is mandatory if we are to minimize the number of hospital admissions for decompensated heart failure.

(Arch Intern Med 1988;148:2013-2016)

Author Affiliations
From the Department of Medicine, Division of Adult Cardiology, Cook County Hospital and University of Illinois at Chicago. Presented in part at the 59th Annual Scientific Sessions of the American Heart Association, Dallas, Nov 20, 1986.

Footnotes
Accepted for publication May 4, 1988.

Reprint requests to the Division of Adult Cardiology, Cook County Hospital, 1835 W Harrison St, Chicago, IL 60612 (Dr Ghali).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Predictors of Early Hospital Readmission After Acute Pulmonary Embolism
Aujesky et al.
Arch Intern Med 2009;169:287-293.
ABSTRACT | FULL TEXT  

Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology
Hawkins et al.
Eur J Heart Fail 2009;11:130-139.
ABSTRACT | FULL TEXT  

Early and Long-term Outcomes of Heart Failure in Elderly Persons, 2001-2005
Curtis et al.
Arch Intern Med 2008;168:2481-2488.
ABSTRACT | FULL TEXT  

Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients With Coronary Heart Disease
Whooley et al.
JAMA 2008;300:2379-2388.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Nurse-Led Disease Management for Heart Failure in an Ethnically Diverse Urban Community
Hebert et al.
ANN INTERN MED 2008;149:540-548.
ABSTRACT | FULL TEXT  

Factors Identified as Precipitating Hospital Admissions for Heart Failure and Clinical Outcomes: Findings From OPTIMIZE-HF
Fonarow et al.
Arch Intern Med 2008;168:847-854.
ABSTRACT | FULL TEXT  

Hospital Discharge Education for Patients With Heart Failure: What Really Works and What Is the Evidence?
Paul
Crit Care Nurse 2008;28:66-82.
FULL TEXT  

Pharmacist Intervention to Improve Medication Adherence in Heart Failure: A Randomized Trial
Murray et al.
ANN INTERN MED 2007;146:714-725.
ABSTRACT | FULL TEXT  

Identifying Heart Failure Patients at High Risk for Near-Term Cardiovascular Events With Serial Health Status Assessments
Kosiborod et al.
Circulation 2007;115:1975-1981.
ABSTRACT | FULL TEXT  

Revascularization in patients with heart failure.
Tsuyuki et al.
CMAJ 2006;175:361-365.
ABSTRACT | FULL TEXT  

Hemodynamic Goals Are Relevant
Stevenson et al.
Circulation 2006;113:1020-1033.
FULL TEXT  

Compliance in heart failure patients: the importance of knowledge and beliefs
van der Wal et al.
Eur Heart J 2006;27:434-440.
ABSTRACT | FULL TEXT  

Medication and Dietary Compliance Beliefs in Heart Failure
Bennett et al.
West J Nurs Res 2005;27:977-993.
ABSTRACT  

Depression and Medication Adherence in Outpatients With Coronary Heart Disease: Findings From the Heart and Soul Study
Gehi et al.
Arch Intern Med 2005;165:2508-2513.
ABSTRACT | FULL TEXT  

Improving Medication Knowledge Among Older Adults With Heart Failure: A Patient-Centered Approach to Instruction Design
Morrow et al.
Gerontologist 2005;45:545-552.
ABSTRACT | FULL TEXT  

Particulate Air Pollution and the Rate of Hospitalization for Congestive Heart Failure among Medicare Beneficiaries in Pittsburgh, Pennsylvania
Wellenius et al.
Am J Epidemiol 2005;161:1030-1036.
ABSTRACT | FULL TEXT  

The role of nurses in the management of heart failure
Grange
Heart 2005;91:ii39-ii42.
ABSTRACT | FULL TEXT  

Discharge Education Improves Clinical Outcomes in Patients With Chronic Heart Failure
Koelling et al.
Circulation 2005;111:179-185.
ABSTRACT | FULL TEXT  

Non-compliance in patients with heart failure; how can we manage it?
van der Wal et al.
Eur J Heart Fail 2005;7:5-17.
ABSTRACT | FULL TEXT  

Deconstructing Heart Failure Disease Management
Wagner
ANN INTERN MED 2004;141:644-646.
FULL TEXT  

Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program
Atienza et al.
Eur J Heart Fail 2004;6:643-652.
ABSTRACT | FULL TEXT  

Instruments to measure acceptability of information and acquisition of knowledge in patients with heart failure
Gwadry-Sridhar et al.
Eur J Heart Fail 2003;5:783-791.
ABSTRACT | FULL TEXT  

Noncardiac comorbidity increases preventable hospitalizations and mortality among medicare beneficiaries with chronic heart failure
Braunstein et al.
J Am Coll Cardiol 2003;42:1226-1233.
ABSTRACT | FULL TEXT  

Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards
De Geest et al.
Eur J Heart Fail 2003;5:557-567.
ABSTRACT | FULL TEXT  

Race, Quality of Care, and Outcomes of Elderly Patients Hospitalized With Heart Failure
Rathore et al.
JAMA 2003;289:2517-2524.
ABSTRACT | FULL TEXT  

Outcomes of Chronic Heart Failure
Benatar et al.
Arch Intern Med 2003;163:347-352.
ABSTRACT | FULL TEXT  

Hemodilution Is Common in Patients With Advanced Heart Failure
Androne et al.
Circulation 2003;107:226-229.
ABSTRACT | FULL TEXT  

Effect of Erythropoietin on Exercise Capacity in Patients With Moderate to Severe Chronic Heart Failure
Mancini et al.
Circulation 2003;107:294-299.
ABSTRACT | FULL TEXT  

Contemporary management of heart failure in clinical practice
Cleland
Heart 2002;88:ii5-8.
FULL TEXT  

Clinical depression is common and significantly associated with reduced survival in patients with non-ischaemic heart failure
Faris et al.
Eur J Heart Fail 2002;4:541-551.
ABSTRACT | FULL TEXT  

Improving Outcomes in Heart Failure: It's Not Unusual Beyond Usual Care
Moser and Mann
Circulation 2002;105:2810-2812.
FULL TEXT  

Reducing hospitalizations for heart failure
Mosterd and Hoes
Eur Heart J 2002;23:842-845.
FULL TEXT  

Hospitalization of patients with heart failure. A population-based study
Cowie et al.
Eur Heart J 2002;23:877-885.
ABSTRACT | FULL TEXT  

A randomized trial of the efficacy of multidisciplinary care in heart failure outpatients at high risk of hospital readmission
Kasper et al.
J Am Coll Cardiol 2002;39:471-480.
ABSTRACT | FULL TEXT  

Failing ageing hearts
Petrie et al.
Eur Heart J 2001;22:1978-1990.
 

Acute Precipitants of Congestive Heart Failure Exacerbations
Tsuyuki et al.
Arch Intern Med 2001;161:2337-2342.
ABSTRACT | FULL TEXT  

Quality Indicators for the Management of Heart Failure in Vulnerable Elders
Fonarow
ANN INTERN MED 2001;135:694-702.
FULL TEXT  

Cardiovascular critical event pathways for the progression of heart failure; a report from the ATLAS study
Cleland et al.
Eur Heart J 2001;22:1601-1612.
ABSTRACT  

Ambulatory heart failure management in private practice in France
Komajda et al.
Eur J Heart Fail 2001;3:503-507.
ABSTRACT | FULL TEXT  

The effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron: a randomized controlled study
Silverberg et al.
J Am Coll Cardiol 2001;37:1775-1780.
ABSTRACT | FULL TEXT  

Heart Failure in the 21st Century: A Cardiogeriatric Syndrome
Rich
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001;56:88M-96.
ABSTRACT | FULL TEXT  

Intermittent non-adherence with ACE inhibitor treatment and its implications for clinical trials results
MacFadyen et al.
Heart 2001;85:213-214.
FULL TEXT  

Nurse-led heart failure clinics in Sweden
Stromberg et al.
Eur J Heart Fail 2001;3:139-144.
ABSTRACT | FULL TEXT  

Team Management of Patients With Heart Failure : A Statement for Healthcare Professionals From the Cardiovascular Nursing Council of the American Heart Association
Grady et al.
Circulation 2000;102:2443-2456.
FULL TEXT  

The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations
Silverberg et al.
J Am Coll Cardiol 2000;35:1737-1744.
ABSTRACT | FULL TEXT  

Systematic review of the management of atrial fibrillation in patients with heart failure
Khand et al.
Eur Heart J 2000;21:614-632.
ABSTRACT  

The basics of heart failure management: are they being ignored?
Horan et al.
Eur J Heart Fail 2000;2:101-105.
ABSTRACT | FULL TEXT  

Nonadherence with angiotensin-converting enzyme inhibitor therapy: A comparison of different ways of measuring it in patients with chronic heart failure
Struthers et al.
J Am Coll Cardiol 1999;34:2072-2077.
ABSTRACT | FULL TEXT  

Non-adherence with ACE inhibitor treatment is common in heart failure and can be detected by routine serum ACE activity assays
Struthers et al.
Heart 1999;82:584-588.
ABSTRACT | FULL TEXT  

Reduction in Heart Failure Events by the Addition of a Clinical Pharmacist to the Heart Failure Management Team: Results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study
Gattis et al.
Arch Intern Med 1999;159:1939-1945.
ABSTRACT | FULL TEXT  

Cost-effectiveness Analysis in Clinical Practice: The Case of Heart Failure
Rich and Nease
Arch Intern Med 1999;159:1690-1700.
ABSTRACT | FULL TEXT  

Prediction of hospital readmission for heart failure: development of a simple risk score based on administrative data
Philbin and DiSalvo
J Am Coll Cardiol 1999;33:1560-1566.
ABSTRACT | FULL TEXT  

Users' Guides to the Medical Literature: XV. How to Use an Article About Disease Probability for Differential Diagnosis
Richardson et al.
JAMA 1999;281:1214-1219.
FULL TEXT  

Racial Differences in the Outcome of Left Ventricular Dysfunction
Dries et al.
NEJM 1999;340:609-616.
ABSTRACT | FULL TEXT  

Nurse led, multidisciplinary intervention in chronic heart failure
MCMURRAY and STEWART
Heart 1998;80:430-431.
FULL TEXT  

Prevention of relapse in patients with congestive heart failure: the role of precipitating factors
Feenstra et al.
Heart 1998;80:432-436.
ABSTRACT | FULL TEXT  

Preventable causative factors leading to hospital admission with decompensated heart failure
Michalsen et al.
Heart 1998;80:437-441.
ABSTRACT | FULL TEXT  

Impact of Medication Nonadherence on Coronary Heart Disease Outcomes: A Critical Review
McDermott et al.
Arch Intern Med 1997;157:1921-1929.
ABSTRACT  

A Multidisciplinary Intervention to Prevent the Readmission of Elderly Patients with Congestive Heart Failure
Rich et al.
NEJM 1995;333:1190-1195.
ABSTRACT | FULL TEXT  

Hospitalization for Congestive Heart Failure: Explaining Racial Differences
Alexander et al.
JAMA 1995;274:1037-1042.
ABSTRACT  

Management of Heart Failure: II. Counseling, Education, and Lifestyle Modifications
Dracup et al.
JAMA 1994;272:1442-1446.
ABSTRACT  

Heart Failure and Noncompliance in the Elderly
Ghali
Arch Intern Med 1994;154:2109-2110.
ABSTRACT  

Effect of Perceived Barriers on Compliance with Antihypertensive Medication
Richardson et al.
Health Educ Behav 1993;20:489-503.
ABSTRACT  

Trends in Hospitalization Rates for Heart Failure in the United States, 1973-1986: Evidence for Increasing Population Prevalence
Ghali et al.
Arch Intern Med 1990;150:769-773.
ABSTRACT