Related Experiment Videos
Identification of cardiovascular risk factors in homeless adults
Molly I Szerlip1, Harold M Szerlip
1Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA. hszerlip@mail.mcg.edu
Insights
Homeless adults have higher rates of hypertension and smoking, key cardiovascular disease risks. Targeted educational and preventive programs are crucial for this vulnerable population.
Area of Science:
- Public Health
- Cardiology
- Health Disparities
Background:
- Cardiovascular disease (CVD) poses a significant health challenge for homeless adults.
- Identifying reversible cardiac risk factors in this population is critical for effective intervention.
- Previous research has not fully elucidated the prevalence of common cardiac risk factors among the homeless.
Purpose of the Study:
- To identify prevalent and reversible cardiovascular risk factors in the homeless population.
- To compare the prevalence of hypertension, diabetes mellitus type 2, cigarette smoking, and hypercholesterolemia between homeless and nonhomeless individuals.
- To inform the development of targeted public health strategies for cardiovascular risk reduction in the homeless.
Main Methods:
- Retrospective chart review of 100 homeless patients from a New Orleans clinic.
- Comparison with 200 matched nonhomeless patients from an inner-city primary care clinic.
- Analysis of prevalence for hypertension, diabetes mellitus type 2, smoking, and hypercholesterolemia.
Main Results:
- Hypertension was significantly more prevalent in homeless individuals (65%) compared to nonhomeless controls (52%) (P < 0.05).
- Cigarette smoking was substantially higher among the homeless (75%) than the nonhomeless (57%) (P < 0.005).
- No significant differences were observed in the prevalence of diabetes mellitus type 2 or hypercholesterolemia.
Conclusions:
- Smoking and hypertension are significantly more prevalent in the homeless population.
- There is an excessive representation of hypertension and smoking within the homeless demographic compared to national data.
- Educational and preventive programs are essential to mitigate CVD and reduce healthcare resource utilization in the homeless.
Background:
Cardiovascular disease is an important health problem among homeless adults; however, the common cardiac risk factors present in this population are unknown. This study was undertaken to identify the reversible cardiovascular risks present in the homeless.
Methods:
A retrospective chart review was performed randomly on 100 patients who were seen at a homeless clinic in New Orleans, Louisiana. These patients were compared with 200 matched nonhomeless patients who attended an inner-city primary care clinic. Each chart from the 2 groups was reviewed for the presence of hypertension, diabetes mellitus type 2, cigarette smoking, and hypercholesterolemia. Statistical comparisons were made between the homeless and the control subjects.
Results:
Hypertension was present in 65% of the homeless but only 52% of the nonhomeless [P < 0.05; odds ratio 1.78 (CI, 1.09 to 2.9)]. Smoking was far more common in the homeless than the nonhomeless, 75 versus 57%, respectively [P < 0.005; odds ratio 2.22 (CI, 1.27 to 3.88)]. There was no difference in the prevalence of diabetes or total cholesterol. Compared with national data hypertension, smoking and diabetes seem to be represented excessively in the homeless population.
Conclusions:
Smoking and hypertension are significantly more prevalent in the homeless population than in a matched cohort. Educational and preventive programs are needed to reduce the prevalence of cardiovascular disease and reduce the overutilization of expensive healthcare resources.