Equal Treatment, Unequal Outcomes? Debunking the Racial Disparity in Renin Angiotensin Aldosterone System Inhibitor-Associated Reduction in Heart Failure Hospitalizations.

Background: Renin angiotensin aldosterone system inhibitors (RAASi) are a mainstay treatment in patients with heart failure with reduced ejection fraction (HFrEF) in part to prevent hospitalizations. However, whether RAASi reduce the risk of hospitalization in Black patients is not entirely clear because enrollment of Black patients in previous clinical trials was low and a previous meta-analysis showed a significant racial disparity: reduction in hospitalizations with an RAASi in White patients but not Black patients. Previous studies relied on the use of self-identified race instead of genomic ancestry.