Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County
Abstract Objective To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami‐Dade Co...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Aging Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/agm2.12272 |
| _version_ | 1797353509114347520 |
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| author | Suhas Seshadri Orly Morgan Alana Moore Shivangi Parmar Julie Schnur Guy Montgomery Armen Henderson Joshua Laban |
| author_facet | Suhas Seshadri Orly Morgan Alana Moore Shivangi Parmar Julie Schnur Guy Montgomery Armen Henderson Joshua Laban |
| author_sort | Suhas Seshadri |
| collection | DOAJ |
| description | Abstract Objective To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami‐Dade County, Florida. In addition, we will compare outcomes found in the study cohort to that of the general population. Methods Demographic information, clinical history, blood pressure control medication prescription, and blood pressure measurements were taken by a Street Medicine team of medical providers. The team routinely provides medical evaluations and care for people experiencing unsheltered homelessness who reside in rough sleeper tent encampments located on the street. Clinical information and vitals were recorded in REDCap. De‐identified data from patients 65 years and above were downloaded and compared to a general population data set—the Centers for Disease Control National Health and Nutrition Examination Survey (CDC NHANES) 2017–2020 Pre‐pandemic cohort. Data analysis was performed using R Studio version 4.3.2. Results Blood pressure was reported in 120 distinct interactions with older people experiencing homelessness. Compared to the age‐matched NHANES data, older people experiencing unsheltered homelessness were at significantly increased relative risk for elevated blood pressure within the range of Stage 1 Hypertension (RR: 3.914, 95% CI: 2.560–5.892, P < 0.001), and within range of Stage 2 Hypertension (RR: 5.550, 95% CI: 4.272–7.210, P < 0.001). According to NHANES, 49.6% of adults over 60 with diagnosed hypertension receive treatment. Of study participants, 69% of those with elevated blood pressure had previously received a diagnosis of hypertension and 15.9% on medication to control blood pressure. Conclusion Our cohort of older people experiencing unsheltered homelessness had higher rates of elevated blood pressure and reduced rates of hypertension diagnosis and treatment as compared to the general population. Older people experiencing unsheltered homelessness are a growing population, and future research should seek to evaluate and understand older adult care vulnerabilities, including chronic disease management, to improve health outcomes for those who are aging, hypertensive, and unhoused. |
| first_indexed | 2024-03-08T13:32:06Z |
| format | Article |
| id | doaj.art-0e96ee87252d4f09beffa002a91d87e7 |
| institution | Directory Open Access Journal |
| issn | 2475-0360 |
| language | English |
| last_indexed | 2024-03-08T13:32:06Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Aging Medicine |
| spelling | doaj.art-0e96ee87252d4f09beffa002a91d87e72024-01-17T07:41:07ZengWileyAging Medicine2475-03602023-12-016432032710.1002/agm2.12272Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade CountySuhas Seshadri0Orly Morgan1Alana Moore2Shivangi Parmar3Julie Schnur4Guy Montgomery5Armen Henderson6Joshua Laban7Department of Internal Medicine University of Illinois Chicago Chicago Illinois USADepartment of Internal Medicine University of Miami Miller School of Medicine Miami Florida USADepartment of Internal Medicine University of Miami Miller School of Medicine Miami Florida USADepartment of Internal Medicine University of Miami Miller School of Medicine Miami Florida USADepartment of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York USADepartment of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York USADepartment of Internal Medicine University of Miami Miller School of Medicine Miami Florida USADepartment of Internal Medicine University of Miami Miller School of Medicine Miami Florida USAAbstract Objective To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami‐Dade County, Florida. In addition, we will compare outcomes found in the study cohort to that of the general population. Methods Demographic information, clinical history, blood pressure control medication prescription, and blood pressure measurements were taken by a Street Medicine team of medical providers. The team routinely provides medical evaluations and care for people experiencing unsheltered homelessness who reside in rough sleeper tent encampments located on the street. Clinical information and vitals were recorded in REDCap. De‐identified data from patients 65 years and above were downloaded and compared to a general population data set—the Centers for Disease Control National Health and Nutrition Examination Survey (CDC NHANES) 2017–2020 Pre‐pandemic cohort. Data analysis was performed using R Studio version 4.3.2. Results Blood pressure was reported in 120 distinct interactions with older people experiencing homelessness. Compared to the age‐matched NHANES data, older people experiencing unsheltered homelessness were at significantly increased relative risk for elevated blood pressure within the range of Stage 1 Hypertension (RR: 3.914, 95% CI: 2.560–5.892, P < 0.001), and within range of Stage 2 Hypertension (RR: 5.550, 95% CI: 4.272–7.210, P < 0.001). According to NHANES, 49.6% of adults over 60 with diagnosed hypertension receive treatment. Of study participants, 69% of those with elevated blood pressure had previously received a diagnosis of hypertension and 15.9% on medication to control blood pressure. Conclusion Our cohort of older people experiencing unsheltered homelessness had higher rates of elevated blood pressure and reduced rates of hypertension diagnosis and treatment as compared to the general population. Older people experiencing unsheltered homelessness are a growing population, and future research should seek to evaluate and understand older adult care vulnerabilities, including chronic disease management, to improve health outcomes for those who are aging, hypertensive, and unhoused.https://doi.org/10.1002/agm2.12272hypertensionunhoused personsshelterless persons |
| spellingShingle | Suhas Seshadri Orly Morgan Alana Moore Shivangi Parmar Julie Schnur Guy Montgomery Armen Henderson Joshua Laban Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County Aging Medicine hypertension unhoused persons shelterless persons |
| title | Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County |
| title_full | Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County |
| title_fullStr | Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County |
| title_full_unstemmed | Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County |
| title_short | Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami‐Dade County |
| title_sort | analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of miami dade county |
| topic | hypertension unhoused persons shelterless persons |
| url | https://doi.org/10.1002/agm2.12272 |
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