THURSDAY, May 19, 2005 (HealthDay News) -- Homeless people aren't receiving care for serious cardiovascular risk factors such as smoking, high blood pressure and diabetes, even under Canada's universal health care system, according to a study by Toronto researchers.
"Fifteen percent of the homeless subjects in the study already had cardiovascular disease, which is surprisingly high," study senior author Dr. Stephen W. Hwang, research scientist at the Centre for Research on Inner City Health at St. Michael's Hospital and assistant professor of medicine at the University of Toronto, said in a prepared statement.
Reporting in this week's issue of the journal Circulation, Hwang's group examined the health of 202 people, averaging 42 years of age, all living in homeless shelters in Toronto. They interviewed each homeless person, conducted physical examinations and took blood samples to assess cardiovascular risk.
Compared to the general population, the homeless had much higher rates of smoking but not diabetes, hypertension or obesity. However, most of the homeless affected by these risk factors had not received adequate treatment for hypertension, high blood cholesterol and had poor control of diabetes, the researchers said.
For example, the study found that 35 percent of the homeless people suffered from hypertension but only 17 percent were taking medication.
Hwang noted that of those with cardiovascular disease, only 20 percent were taking cholesterol-lowering medication and only 30 percent were taking aspirin.
Among the homeless men, the estimated average risk of suffering a heart attack or dying of coronary disease within the next 10 years was five percent, about the same as men in the general population. This risk was assessed using the Framingham risk assessment tool, which looks at risk factors such as age, male gender and high blood pressure.
"But the commonly used Framingham risk assessment tool doesn't account for factors that are common among homeless people, such as the level of smoking exposure and cocaine use," Hwang said. Both of these habits are major risk factors for cardiac events such as heart attack or stroke.
Hwang noted that 78 percent of the homeless people in the study smoked -- much higher than the Canadian average -- and that 29 percent reported using cocaine within the previous year.
Experts estimate that more than 800,000 individuals in North America are homeless in any given week.
The American Heart Association has more about heart disease risk factors.