{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T22:36:39Z","timestamp":1772231799930,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effect of different pharmacological therapies for heart failure (HF) between the Black vs. White population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We included randomized controlled trials (RCT) of HF pharmacological therapies with explicit strata of Black or White adults in the primary or secondary analysis. We examined three outcomes: (1) the composite of CV death or hospitalization for heart failure (HHF), (2) HHF, and (3) all-cause death. Within each race (White and Black), we calculated the pooled risk ratio (RR) with a 95% confidence interval (CI) of different pharmacological therapies using random-effects models. Within each pharmacological therapies, we assess the differences in the treatment effect by race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 19 RCT reporting eight pharmacological therapies, there was no significant difference between the Black and White groups for using sacubitril\/valsartan, angiotensin-converting enzyme inhibitors, calcium-channel blockers, direct renin inhibitors, oral soluble guanylate cyclase, or vasodilators. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) had a different effect in HHF across the White and Black patients (P<jats:sub>interaction<\/jats:sub>\u2009=\u2009.030), with a better treatment effect observed in the Black (RR 0.39, 95% CI 0.19\u20130.80) compared to the White group (0.90, 0.71\u20131.14). Beta-blockers had a better treatment effect in the White (0.65, 0.52\u20130.81) compared to the Black group (1.14, 0.88\u20131.47) regarding the all-cause death outcome (P<jats:sub>interaction<\/jats:sub>\u2009=\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Black individuals with HF appeared to obtain a greater benefit of HHF risk reduction from SGLT2i and less benefit for mortality from beta-blockers compared to their White counterparts.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1482311","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T05:27:15Z","timestamp":1751261235000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of pharmacological therapies for heart failure in Black vs. White populations: a meta-analysis of randomized controlled trials of heart failure treatment"],"prefix":"10.3389","volume":"12","author":[{"given":"Yujia","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huilin","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenxi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Han","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao-Hsuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Bian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa M.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen 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