Responses on familiarity with JR did not mediate the relationship between ethnicity and attitudes toward JR. CONCLUSION: Differences in attitudes toward JR between AA and white patients is mediated by post-surgical concerns about pain and disability. If confirmed, our findings suggest an opportunity for generalists to address patient-level factors that contribute to racial disparity in the utilization of joint replacement. PURPOSE: Although racial and gender differences in mortality have been reported for systolic heart failure, little is known regarding diastolic heart failure prognosis; even though diastolic heart failure is the most common type of heart failure in the US. METHODS: Our sample consisted of 1058 patients 65 years of age or older who were admitted to 30 hospitals in Northeastern Ohio with a principal diagnosis of heart failure and had documented diastolic dysfunction by Echo. Diastolic heart failure in this cohort was defined as`h aving a principal diagnosis of heart failure and a LVEF of Ê 50% by Echo.'' Mortality data for all patients were obtained from Ohio MEDPRO files for Medicare beneficiaries. Logistic regression was used to compare 18-month mortality by ethnicity and by gender, adjusting for age, gender and comorbidities. RESULTS: Of the 1058 patients with documented diastolic heart failure (13% AA and 87% white), AAs and whites were comparable with respect to history of angina, stroke, being on dialysis, alcohol use, and the proportion of males. AAs were more likely to have hypertension (50% vs 36%; P = 0.001), diabetes (46% vs 29%; P = 0.000), history of tobacco use (27% vs 18%; P = 0.011), and high serum creatinine (1.99 2 vs 1.50 1; P = 0.003); they were also younger (76 7 vs 79 8; P = 0.000). Whites were more likely to have a history of ischemic heart disease (48% vs 32%; P = 0.000), metastatic cancer (3% vs 0%; P = 0.034), DNR status on record (14% vs 7%; P = 0.013), and atrial fibrillation (24% vs 14%; P = 0.002). The AA to white adjusted OR for 18-month mortality was 1.03 (0.66 ± 1.59). For men vs women (30% vs 70%), the above-mentioned comorbidities were comparable, except women were more likely to have DNR status (16% vs 7.3%; P = 0.000) and to be older (79.5 8 vs 77 7; P = 0.000). Males were more likely to have a history of tobacco use (30% vs 14%; P = 0.000), alcohol use (36% vs 15%; P = 0.000), and higher serum creatinine level (1.7 1.2 vs 1.4 1.1; P = 0.001). Men to women adjusted OR for 18-month mortality 1.06 (0.76 ± 1.46). CONCLUSION: In this cohort of elderly patients admitted with diastolic heart failure, there were no ethnic or gender differences in 18-month mortality.