Underuse of hydralazine/nitrate (HYD/NIT) in black patients with heart failure and reduced ejection fraction (HFrEF) has been previously described, but whether this important treatment gap persists in contemporary practice is unknown.
Despite differences in the heart failure phenotype, therapy of heart failure in African Americans remains largely the same as in white heart failure cohorts, with the notable exception of the added benefits provided by combination of hydralazine and isosorbide dinitrate (HYD-ISDN), now regarded as highly indicated therapy by both the Heart Failure Society of America and the American College of Cardiology/American Heart Association heart failure guideline committees.