Article Figures & Data
Tables
- Table 1
Study Variables Among Homeless and Nonhomeless Hypertensive Patients, New York City, 2014
Variable Total Patients N = 210 Homeless (n = 177) Nonhomeless (n = 33) Sociodemographic characteristic Age, mean (SD) [range], ya 55.74 (10.99) [28–92] 55.10 (11.07) 59.15 (10.01) Systolic blood pressure, mean (SD) [range], mm Hg 131.04 (19.47) [86–210] 131.76 (20.05) 127.18 (15.70) Diastolic blood pressure, mean (SD) [range], mm Hg 79.76 (12.34) [30–111] 80.06 (12.91) 78.18 (8.71) Blood pressure level (n = 210) Normal (<135/85 mm Hg), No. (%) 46 (21.9) 38 (21.4) 8 (24.2) At risk (≥135/85 to <140/90 mm Hg), No. (%)c 82 (39) 68 (38.4) 14 (42.4) Stage 1, uncontrolled (≥140/90 to <160/100 mm Hg), No. (%) 53 (25.2) 43 (24.2) 10 (30.3) Stage 2, very uncontrolled (≥160/100), No. (%) 29 (13.8) 28 (15.8) 1 (0.03) Hypertension, uncontrolled (n = 210), No. (%) 82 (39) 71 11 Sex (n = 210), male, No. (%) 158 (75.2) 136 22 Race (n = 206) White, No. (%) 32 (15.5) 26 6 African American, No. (%) 114 (55.3) 101 13 Hispanic, No. (%) 40 (19.4) 31 9 Asian, Native American, others, No. (%) 20 (9.7) 17 3 Health insurance (n = 209), No. (%)b 180 (86.1) 147 33 Insurance type (n = 176) Medicaid, No. (%) 118 (67) 100 18 Medicare, No. (%) 56 (31.8) 41 15 Other, No. (%) 2 (1.1) 2 0 Clinical indicator Diabetes (n = 204), No. (%) 75 (36.8) 60 15 Coronary artery diseases (n = 204), No. (%)a 41 (20.1) 30 11 Kidney disease (n = 204), No. (%) 8 (3.9) 5 3 Hypercholesterolemia (n = 204), No. (%)b 63 (30.9) 44 19 Number of chronic diseases (n = 176), mean (SD) [range]b 1.91 (0.97) [0–5 ] 1.82 (0.93) 2.39 (1.02) Mental illness (n = 201), No. (%) 127 (63.2) 104 23 Number of mental illness (n = 100), mean (SD) [range] 1.18 (0.44) [0–3] 1.16 (0.44) 1.26 (0.45) Body mass index (n = 205), mean (SD) [range] 30.55 (6.97) [18.36–51.24] 30.36 (6.42) 31.58 (9.36) Obesity (n = 176), No. (%) 95 (46.6) 79 16 Substance abuse (n = 160), No. (%) 30 (18.8) 25 5 Alcohol abuse (n = 164), No. (%)a 25 (15.2) 24 1 Smoking cigarettes (n = 181), No. (%)a 89 (49.2) 80 9 Number of current daily cigarettes (n = 84), mean (SD) [range] 9.08 (5.71) [2–31] 8.98 (5.47) 9.89 (7.84) - Table 2
Bivariate Analysis of Hypertension Among Homeless Hypertensive Patients, New York City, 2014
Variable Total Patients n = 177 Controlled Hypertension n = 106 (59.9%) Uncontrolled Hypertension n = 71 (40.1%) Age (n = 177), mean (SD) [range], y 55.10 (11.07) [28–92] 55.27 (10.65) 54.85 (11.76) Duration of homelessness (n = 39), mean (SD) [range], y 3. 07 (5.04) [0.03–23] 3.08 (4.24) 3.07 (5.97) Systolic blood pressure (n = 177), mean (SD) [range]b 131.76 (20.05) [86–210] 118.85 (10.99) 151.03 (14.17) Diastolic blood pressure (n = 177), mean (SD) [range]b 80.06 (12.91) [30–111] 73.71 (8.73) 89.54 (12.34) Blood pressure level (n = 177) Normal (<135/85 mm Hg), No. (%) 38 (21.5) … … At risk (≥135/85 to <140/90 mm Hg) 68 (38.4) … … Stage 1, uncontrolled (≥140/0 to <160/100 mm Hg) 43 (24.3) … … Stage 2, very uncontrolled (≥160/100 mm Hg) 28 (15.8) … … Sex, male (n = 177) 136 (76.8) 79 57 Race (n = 175) White, No. (%) 26 (14.9) 15 11 African American, No. (%) 101 (57.7) 58 43 Hispanic, No. (%) 31 (17.7) 19 12 Asian, Native American, others, No. (%) 17 (9.7) 13 4 Health insurance (n = 176), No. (%)a 147 (83.5) 93 54 Insurance type (n = 143) Medicaid, No. (%) 100 (69.9) 62 38 Medicare, No. (%) 41 (28.7) 29 12 Other, No. (%) 2 (1.4) 0 2 Diabetes (n = 171), No. (%)b 60 (35.1) 45 15 Coronary artery disease (n = 171), No. (%) 30 (17.5) 19 11 Kidney disease (n = 171), No. (%) 5 (2.9) 3 2 Hypercholesterolemia (n = 171), No. (%) 44 (25.7) 31 13 Mental illness (n = 168), No. (%)a 104 (61.9) 70 34 Number of mental illness (n = 100), mean (SD) [range] 1.16 (0.44) [0–3] 1.17 (0.45) 1.15 (0.43) Body mass index (n = 172), mean (SD) [range] 30.36 (6.42) [18–49] 30.68 (6.07) 29.87 (6.93) Obesity (n = 171), No. (%) 79 (46.2) 51 28 Substance abuse (n = 131), No. (%) 25 (19.1) 15 10 Alcohol abuse (n = 133), No. (%) 24 (18) 12 12 Smoking cigarettes (n = 150), No. (%) 80 (53.3) 50 30 Number of current daily cigarettes (n = 76), mean (SD) [range] 8.98 (5.47) [2–31] 8.99 (5.92) 8.96 (4.67) - Table 3
Logistic Regression Analysis of Independent Variables on Uncontrolled Hypertension Among Homeless Adults, New York City, 2014
Variable Uncontrolled Hypertension Unadjusted OR 95% CI Adjusted ORa 95% CI Age … … 1.007 0.97–1.03 Health insuranceb 0.41 0.18–0.92 0.39 0.16–0.97 Diabetes 0.35 0.17–0.70 0.38 0.18–0.81 Hypercholesterolemiab 0.53 0.25–1.11 0.52 0.23–1.19 Mental illnessb 0.45 0.24–0.86 0.42 0.21–0.84
Additional Files
The Article in Brief
Rates and Predictors of Uncontrolled Hypertension Among Hypertensive Homeless Adults Using New York City Shelter-Based Clinics
Ramin Asgary , and colleagues
Background As the homeless population ages, they are at higher risk of developing hypertension (high blood pressure). This study assesses the rates and predictors of uncontrolled blood pressure among hypertensive homeless and non-homeless adults using New York City's shelter-based clinics.
What This Study Found There is an alarmingly high rate of uncontrolled hypertension among homeless adults. In this study, forty percent of homeless patients have uncontrolled blood pressure. In comparison, the rates of uncontrolled blood pressure among hypertensive adults who are under treatment are 20 percent (for those aged 40 to 59 years) and 25 percent (for those 60 to 79 years). Lack of health insurance is a strong predictor of uncontrolled blood pressure among homeless and non-homeless hypertensive adults using shelter-based clinics.
Implications
- Hypertension is less controlled among the homeless, who often lack social support and resources to cope with its complications.
- The authors call for comprehensive approaches to provide targeted social services, address psychosocial issues, and improve health insurance for the homeless, as well as strategies to prevent and address homelessness.
