Heart failure (HF) and cardiovascular disease have reached epidemic levels in Latin American (LATAM), with rising age-standardized mortality rates, and the disparities seen in women worldwide in terms of diagnosis and treatment are also relevant when it comes to HF in LATAM women. Collaboration between health care systems, professional organizations, governmental entities, among others, is needed to reduce these inequalities, according to an article published Jan. 8 in the Journal of Cardiac Failure.

Cesar J. Herrera, MD, FACC, et al., write in their call to action that HF in low-and-middle-income countries, and especially among LATAM women, is a rarely addressed topic in the scientific community. Some 335 million women live in the 33 countries comprising LATAM.

The authors write that some features of HF in women in LATAM include a generally younger population, a strong influence of reproductive risk factors, a high prevalence of rheumatic heart disease, Chagas cardiomyopathy and untreated congenital heart disease, and possibly more HFrEF than HFpEF, but that more research is needed to fully characterize it. Among relevant social determinants of health are rural residence and related limitations in transportation; racial, cultural and religious beliefs; and lower health expenditure than in developed nations. In addition, women in LATAM “constitute an essential axis in family structures as caretakers and providers of financial support, a fact that, unfortunately, has been linked to lower rates of preventive care use and delays in medical attention.”

“In summary, the urgent need to address HF in LATAM expands beyond the understanding of how social determinants of health impact the well-being of women; it should also embrace specific aspects of HF potentially unique to the region, including the influence of genetics, specific etiologies and clinical expressions,” they write.

Learn more about the challenges in this population from Dr. Herrera in an ACC.24 Session (#628) “I Want To Break Free: Overcoming Disparities in Heart Failure” on April 6.