Homeless adults are nearly twice as likely to have cardiovascular diseases compared with other adults, putting them at greater risk of severe coronavirus and early death, the first large-scale study of its kind has revealed.
Researchers at UCL used UK primary care data collected between 1998 and 2019 to compare 8,482 homeless individuals with 32,134 housed people who were matched by age and gender and lived in the same general practice area.
The data established if the individuals had pre-existing or developed any of the most common types of cardiovascular diseases, including angina, stroke, heart failure and peripheral vascular disease.
Writing in the European Health Journal, they said that as well as having an increased risk of cardiovascular disease, homeless people were also 1.6 times more likely to smoke, four times more likely to drink alcohol to excess, and more likely to have risk factors such as atrial fibrillation, diabetes and chronic lung disease.
The rate of new onset heart disease was nearly three times higher in homeless men, and double in women, compared to other adults. The age at which new cardiovascular diseases occurred was on average five years earlier in homeless people, depending on the type of disease.
Dr Amitava Banerjee, from UCL Institute for Health Informatics, said: “Existing studies show a higher risk of chronic diseases and death among homeless people, but this is the first study to look across a wide range of cardiovascular diseases and see how they develop.
“Our data is crucial to understand the extent to which homeless people have elevated risk of cardiovascular disease and how this can be prevented and treated.”
The study also showed that one-year mortality after the first diagnosis of cardiovascular disease was 15.3% among homeless adults compared to 11.6% among housed people.
Dr Banerjee added: “Overall, homeless people are at greatly increased risk of dying from heart diseases and in the current context, this increased cardiovascular risk conveys a higher mortality risk with COVID-19. More importantly, a great deal of this disease burden, whether new heart disease or deaths, is preventable with better organisation of care.”
Nanjo A, Evans H, Direk K et al. Prevalence, incidence, and outcomes across cardiovascular diseases in homeless individuals using national linked electronic health records. European Heart Journal 19 November 2020
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