Based on information from the American Heart Association and the U.S. Census Bureau, it is estimated that there are approximately 750,000 African Americans with heart failure in the United States and this number is expected to grow to 1 million by 2010.^8,9

While anyone can be affected by heart failure, it hits the African American community the hardest:

• Heart failure has a more aggressive natural history in African Americans¹⁰
• In African Americans, heart failure occurs at an earlier age and is associated with more advanced disease at diagnosis⁵
• In African Americans, heart failure is more likely to be associated with a history of hypertension⁵
• African Americans require hospitalization for heart failure more frequently and at a younger age than do whites⁷
• Among African Americans there is a question of dissimilar responses to medical therapy compared to other races⁵
• The risks for mortality in African American men and women with heart failure are as much as 1.8 and 2.4 fold higher, respectively, than in other populations^5,6

Important information about BiDil®
(isosorbide dinitrate/hydralazine hydrochloride):

INDICATIONS AND USAGE
BiDil is indicated for the treatment of heart failure as an adjunct to standard therapy in self-identified black patients to improve survival, to prolong time to hospitalization for heart failure, and to improve patient reported functional status. There is little experience in patients with NYHA class IV heart failure. Most patients in the clinical trial supporting effectiveness (A-HeFT) received a loop diuretic, an angiotensin converting enzyme inhibitor or an angiotensin II receptor blocker, and a beta blocker, and many also received a cardiac glycoside or an aldosterone antagonist.

CONTRAINDICATIONS
BiDil is contraindicated in patients who are allergic to organic nitrates.

WARNINGS
Augmentation of the vasodilatory effects of isosorbide dinitrate by phosphodiesterase inhibitors such as sildenafil, vardenafil, or tadalafil could result in severe hypotension. The time course and dose dependence of this interaction have not been studied. Reasonable supportive care should consist of those measures used to treat a nitrate overdose with elevation of the extremities and central volume expansion.

ADVERSE REACTIONS
Adverse events reported in A-HeFT and seen more frequently in the group given BiDil included headache (50% in BiDil patients vs. 21% in placebo patients) and dizziness (32% in BiDil patients vs. 14% in placebo patients).

The full Prescribing Information for BiDil is available here.