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The number of older patients in the United States is expected to increase by 69% between 2020 and 2060. In addition, ethnic and racial groups are expected to become the racial majority within the next 35 years. However, heart failure disparities and comorbidity disparities span across different ethnic groups. Socioeconomic factors, race, and conditions associated with heart failure may impact the longevity and the development of heart failure. Caucasian patients with heart failure are more likely to have one or two concurrent comorbidities. In contrast, African American patients are more likely to experience three or four coexisting multimorbid conditions. African American patients were also approximately three times more likely to have all four coexisting conditions (18.5%) when compared to Caucasian patients (7.2%).

One retrospective analysis evaluated the prevalence and distribution of commonly diagnosed comorbid conditions, including hypertension, dyslipidemia, dementia, and diabetes. The study assessed data from 316 heart failure patients aged 80 and older. There was a racial distribution of 65 African Americans and 251 Caucasians. These patients attended the University of Arkansas for Medical Sciences’ geriatric outpatient clinic from 2011 to 2016. The study analyzed the data of patients residing in rural areas,

The study found diagnoses of dyslipidemia, diabetes, and dementia rates were higher among African American patients than Caucasian patients. Specifically, the diagnoses of these conditions were around 20% higher in African Americans than Caucasians. The diagnosis of hypertension was comparable among both racial groups.

A higher prevalence of comorbidities in older African Americans with heart failure may indicate greater healthcare access, socioeconomic status, and health literacy differences. Access and availability barriers significantly affect heart failure risks among patients in economically underserved regions. Clinicians should be aware of the potential link between heart failure and other comorbidities, especially in high-risk patients. By disseminating this knowledge, clinicians can better serve patients while mitigating heart failure’s disability and tremendous economic burden. Additionally, clinicians are encouraged to develop strategies to reduce barriers while engaging and maintaining relationships with older African American patients seeking healthcare.


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Blach, A., Pangle, A., Azhar, G., & Wei, J. (2022). Disparity and multimorbidity in heart failure patients over the age of 80. Gerontology and Geriatric Medicine, 8. https://doi.org/10.1177/23337214221098901