Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

Oliveira, Luís; Pereira, Maria Lurdes; Azevedo, Ana; Lunet, Nuno

doi:10.1590/s0102-311x2012000800010

Cited by 15 publications

(8 citation statements)

References 46 publications

(65 reference statements)

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“…Several surveys have shown that homeless people have a relatively high prevalence of cardiovascular risks, including hyperlipidemia (5,7,13,29), hypertension (5, 7, 10-13, 30), obesity (5, 7-9, 19, 31), diabetes (7,10,13,15,17), smoking (7,(29)(30)(31) and metabolic syndrome (14,17). The direct relationship between the cardiovascular risk parameters and homelessness has been unclear because the actual laboratory data were within the normal ranges (16) or less than in the general population (29). We showed that there were significant correlations between liver dysfunction and being homeless for !…”

Section: Discussionmentioning

confidence: 99%

Non-communicable Disease among Homeless Men in Nagoya, Japan: Relationship between Metabolic Abnormalities and Sociodemographic Backgrounds

et al. 2020

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Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between metabolic abnormalities and the sociodemographic background or mental illness/cognitive disability were analyzed. Results There were significant correlations of liver dysfunction (AST! 35 IU, ALT! 35 IU, γ-GTP! 75 IU), hypertension [systolic/diastolic blood pressure (BP) ! 140/90 mmHg], and dyslipidemia (HDL <40 mg/dL) with the history/duration of homelessness (over 2 times/year) and residence status (living on the streets). Although the mean body mass index (BMI), BP, HbA1c, and LDL in participants living in temporary residences were similar to those obtained from the general population data from National Health Nutrition Survey (NHNS) 2016, the systolic/diastolic BP in those living on the street was significantly higher than in the general population, and the HDL in those living in temporary residences was significantly lower than in those reported in the NHNS 2016 data. In the group with cognitive disability, the ALT, TG, and BMI values were significantly higher and the HDL level significantly lower in those living in temporary residences than in those living on the streets. Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.

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Section: Discussionmentioning

confidence: 99%

Non-communicable Disease among Homeless Men in Nagoya, Japan: Relationship between Metabolic Abnormalities and Sociodemographic Backgrounds

et al. 2020

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“…Previous studies of CVD risk in homeless populations have similarly observed a high prevalence of CVD risk factors and an increased risk for CVD among homeless individuals [ 14 , 28 , 42 , 43 ]. However, many of these studies have been limited in scope, often focusing on particular subsets of the homeless population and/or examining only one risk factor [ 16 , 44 - 47 ], or conducted outside of North America [ 42 , 43 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors and 30-year cardiovascular risk in homeless adults with mental illness

et al. 2015

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BackgroundCardiovascular disease (CVD) is a leading cause of death among homeless people. This study examines CVD risk factors and 30-year CVD risk in a population of homeless individuals with mental illness.MethodsCVD risks factors were assessed in 352 homeless individuals with mental illness in Toronto, Canada, at the time of their enrollment in the At Home/Chez Soi Project, a randomized trial of a Housing First intervention. The 30-year risk for CVD (coronary death, myocardial infarction, and fatal or nonfatal stroke) was calculated using published formulas and examined for association with need for mental health services, diagnosis of psychotic disorder, sex, ethnicity, access to a family physician and diagnosis of substance dependence.ResultsThe 30-year CVD risk for study participants was 24.5 ± 18.4%, more than double the reference normal of 10.1 ± 7.21% (difference = −13.0% 95% CI −16.5% to −9.48%). Univariate analyses revealed 30-year CVD risk was greater among males (OR 3.99, 95% CI 2.47 to 6.56) and those who were diagnosed with substance dependence at baseline (OR 1.94 95% CI 1.23 to 3.06) and reduced among those who were non-white (OR 0.62 95% CI 0.39 to 0.97). In adjusted analyses, only male sex (OR 4.71 95% CI 2.76 to 8.05) and diagnosis of substance dependence (OR 1.78 95% CI 1.05 to 3.00) remained associated with increased CVD risk.ConclusionsHomeless people with mental illness have highly elevated 30-year CVD risk, particularly among males and those diagnosed with substance dependence. This study adds to the literature by reporting on CVD risk in a particularly vulnerable population of homeless individuals experiencing mental illness, and by using a 30-year CVD risk calculator which provides a longer time-frame during which the effect of modifiable CVD risk factors could be mitigated.Trial registrationCurrent Controlled Trials ISRCTN42520374Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1472-4) contains supplementary material, which is available to authorized users.

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“…Although a random sample of the homeless people could not be obtained, the venue-based sampling was conducted in support institutions that are meeting places where homeless tend to concentrate, and are representative of the institutions of the same type in Porto; the other institutions that were invited are similar to those that participated in their objectives and services provided, and are therefore expected to target similar populations 9 . Furthermore, our sample is expected to include at least one-tenth of the homeless living in Porto, since the population of homeless people in the city was estimated to range between 358 and 1,394 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Although the latter may have contributed to the low reporting of medicines used for acute conditions, such as non-steroidal antiinflammatory drugs or cough and cold preparations, the prevalences were much lower the expected. Unpublished data from the general population from the same city 9 shows that anti-dyslipidemic drugs, antihypertensives, anti-inflammatory drugs and other medications (e.g. vitamins, proto-pump inhibitors) are used more often by the general population, whereas among the homeless the prevalence of the use of antiinfectives for systemic use and nervous system drugs (except anti-depressants) is much higher.…”

Section: Discussionmentioning

confidence: 99%

“…Between February and September 2009 we recruited homeless adults through venue-based sampling and systematic selection, as described previously 9 . Briefly, the participants were selected among the subjects attending social services institutions that provide accommodation or assistance; three of the 11 local organizations that were contacted agreed to participate, namely one that provided accommodation to homeless people in two homeless hostels and two institutions that managed meal programs.…”

Section: Methodsmentioning

confidence: 99%

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Use of medicines by homeless people in Porto, Portugal

et al. 2014

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The objective of this study was to describe patterns of medication use among homeless adults from the city of Porto, Portugal. We recruited 146 homeless participants in four social services institutions. Data on the use of medicines in the previous week were collected using face-to-face interviews. We described the prevalence and main correlates of use of medicines from different Anatomical Therapeutic Chemical classification (ATC) groups. A total of 56.8% of the homeless reported to have used at least one medicine in the previous week. The most frequently reported were benzodiazepines (21.9%) and antipsychotics (15.1%); socio-demographic characteristics, lifestyle variables and use of health care were not found to be significantly associated with their use. The prevalence was 1.4% for anti-inflammatory and antirheumatic products, and 6.2% for antihypertensives, diuretics and beta-blocking agents. Medicines pertaining to the nervous system ATC group were by far the most frequently used, while those for the treatment of other common chronic and acute conditions seem to be underused.

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Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

Cited by 15 publications

References 46 publications

Non-communicable Disease among Homeless Men in Nagoya, Japan: Relationship between Metabolic Abnormalities and Sociodemographic Backgrounds

Non-communicable Disease among Homeless Men in Nagoya, Japan: Relationship between Metabolic Abnormalities and Sociodemographic Backgrounds

Cardiovascular risk factors and 30-year cardiovascular risk in homeless adults with mental illness

Use of medicines by homeless people in Porto, Portugal

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