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The risk and burden of cardiovascular disease CVD are higher in homeless than in housed individuals but population-based analyses are lacking. The aim of this study was to investigate prevalence, incidence and outcomes across a range of specific CVDs among homeless individuals.

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For 12 CVDs stable angina; unstable angina; myocardial infarction; sudden cardiac death or cardiac arrest; unheralded coronary death; heart failure; transient ischaemic attack; ischaemic stroke; subarachnoid haemorrhage; intracerebral haemorrhage; peripheral arterial disease; abdominal aortic aneurysmwe estimated prevalence, incidence, and 1-year mortality post-diagnosis, comparing homeless and housed groups. Comorbidities and risk factors were more prevalent in homeless people, e.

CVD prevalence Homeless individuals had higher CVD incidence in all three arterial territories than housed people. CVD in homeless individuals has high prevalence, incidence, and 1-year mortality risk post-diagnosis with earlier onset, and high burden of risk factors.

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Inclusion health and social care strategies should reflect this high preventable and treatable burden, which is increasingly important in the current COVID context. See page for the editorial comment on this article doi: Homelessness affects an estimated million people worldwide. Cardiovascular diseases CVDs are the leading cause of burden of disease in the UK and worldwide, 45 but the majority of research concerning health and healthcare of homeless people has focused on infectious diseases, mental health, and acute crisis management, 2 even though the CVD burden among homeless Psper may be higher than the general population.

Existing studies show higher risk of chronic diseases and death, including CVDs 278 in homeless people, but have considered single or composite measures of CVD, neither looking across different CVDs together, nor the whole population, nor all age categories. In housed individuals, studies across different CVDs have been instructive, whether in comparative epidemiology and time trends, or quality of treatment and prioritization in clinical practice and research, 1617 increasingly using electronic health records EHRs18 but not in homeless populations, which are defined variably across studies and countries.

We conducted a retrospective cohort study Coffee Heart Rate Research Paper national linked EHRs to investigate prevalence, incidence, and outcomes across major CVDs in homeless individuals, compared with housed individuals. CPRD is a primary care database that directly collects de-identified data of individuals from general practices GPs in the UK and is representative of the UK population in terms of age, sex, and ethnicity. Supplementary material onlineTable S 1 provides a full list of the terms.

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We developed an EHR algorithm for homelessness, which was reviewed by a panel of clinical and academic experts in homeless health, including primary and secondary care. Inclusion criteria for study of cardiovascular disease in homeless and housed individuals.

At baseline i. Since IMD is a postcode measure of deprivation and the recorded postcode of a homeless individual is unlikely to be a good measure of their level of deprivation e. Clinical data included body mass index BMIblood pressure, total serum cholesterol, smoking, and alcohol.]