Identification of cardiovascular risk factors in homeless adults

Abstract

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 (Cl, 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 (Cl, 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.