One Size Does Not Fit All: Opportunities for Improving Heart Failure Outcomes in Special Populations




Although modern medicine has substantially improved outcomes in patients with heart failure (HF), the associated morbidity and mortality remain unacceptably high, particularly among special populations of patients, such as older adults, African Americans, patients with renal impairment, and those with diabetes. Clinical practice guidelines provide recommendations to improve these outcomes, yet adherence to guideline recommendations remains suboptimal. Guideline-directed medication therapy (GDMT) is essential to ensuring patients receive appropriate care. Furthermore, many nuances of special population care require knowledge beyond that of guidelines. Clinicians must thoroughly understand how to diagnose and assess these patients, as left ventricular ejection fraction determines management strategy. Up-to-date knowledge of medications and their places in GDMT is essential, as is staying abreast of safety and efficacy data on new and emerging agents. A coordinated, multidisciplinary approach to care is critical to address barriers to effective care. Special populations are often underrepresented in clinical trials and guidelines, so clinicians must be educated on the best evidence-based management of these patients to improve outcomes.



Keith C. Ferdinand, MD, FACC, FAHA
Professor of Medicine
Department of Cardiology
Gerald S. Berenson Endowed Chair in Preventive Cardiology
Tulane University School of Medicine
New Orleans, Louisiana

Martha Gulati, MD, MS, FACC, FAHA
Division Chief, Cardiology
University of Arizona College of Medicine – Phoenix
Phoenix, Arizona


Release date: January 7, 2020
Expiration date: January 7, 2021
Estimated time to complete activity: 30 minutes



This educational initiative has been designed to meet the educational needs of cardiologists and specialty NPs and PAs interested in the treatment of HF.


Upon completion of this educational activity, participants will be able to:

  •  Examine the differences between heart failure with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction (HFmEF), and heart failure with preserved ejection fraction (HFpEF)
  • Incorporate guideline recommendations and recent clinical trial data in the management of special populations, including older adults and African-Americans, as well as HF patients who may have overlapping comorbidities, such as diabetes and renal insufficiency
  • Articulate the importance of multidisciplinary care for special populations of patients with HF

There are no fees for participating and receiving CME credit for this activity. During the period of January 7, 2020 through January 7, 2021 participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 75% or better.




Integrity Continuing Education, Inc. is accredited with commendation by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians.


Integrity Continuing Education, Inc. designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education, Inc. at (855) 835-4004 or


Integrity Continuing Education, Inc. requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education, Inc. for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Keith C. Ferdinand, MD, FACC, FAHA
Consulting Fees: Boehringer Ingelheim, Janssen, Lilly, Novartis, Quantum Genomics

Martha Gulati, MD, MS, FACC, FAHA
No conflicts of interest to report.

The Integrity Continuing Education, Inc. planners/managers have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc. and Novartis Pharmaceuticals Corporation do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc., you will be asked for your name, degree(s), affiliation(s), street address, telephone number, fax number, and…(continued)


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The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.


Provided by Integrity Continuing Education, Inc.


Supported by an educational grant from Novartis Pharmaceuticals Corporation.

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