Evidence map›Paper›PMID 33205821›Full record

ArticleEuropean heart journal2020

Prevalence, incidence, and outcomes across cardiovascular diseases in homeless individuals using national linked electronic health records.

Atsunori Nanjo, Hannah Evans, Kenan Direk, Andrew C Hayward, Alistair Story, Amitava Banerjee

Open access · hybridAbstract readComment
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
7.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 58 citations in OpenAlex.

  1. Trial
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  11. Unmet needs: Bringing physical rehabilitation to people experiencing homelessness.PM & R : the journal of injury, function, and rehabilitation · 2025
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  12. Review
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  17. Ten Priorities for Research Addressing the Intersections of Brain Injury, Mental Health and Addictions: A Stakeholder-Driven Priority-Setting Study.Health expectations : an international journal of public participation in health care and health policy · 2024
    Article
  18. Cardiovascular Disease Screening in homeless: A Feasibility Study.Journal of the American Heart Association · 2024
    Article
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  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Atsunori NanjoInstitute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK.
Hannah EvansInstitute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK.
Kenan DirekInstitute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK.
Andrew C HaywardUCL Institute of Epidemiology and Health Care, UCL, London, UK.
Alistair StoryFind and Treat, University College London Hospitals NHS Trust, London, UK.
Amitava BanerjeeInstitute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK.
University College London · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe 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. METHODS AND

resultsUsing linked UK primary care electronic health records (EHRs) and validated phenotypes, we identified homeless individuals aged ≥16 years between 1998 and 2019, and age- and sex-matched housed controls in a 1:5 ratio. 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 aneurysm), we estimated prevalence, incidence, and 1-year mortality post-diagnosis, comparing homeless and housed groups. We identified 8492 homeless individuals (32 134 matched housed individuals). Comorbidities and risk factors were more prevalent in homeless people, e.g. smoking: 78.1% vs. 48.3% and atrial fibrillation: 9.9% vs. 8.6%, P < 0.001. CVD prevalence (11.6% vs. 6.5%), incidence (14.7 vs. 8.1 per 1000 person-years), and 1-year mortality risk [adjusted hazard ratio 1.64, 95% confidence interval (CI) 1.29-2.08, P < 0.001] were higher, and onset was earlier (difference 4.6, 95% CI 2.8-6.3 years, P < 0.001), in homeless, compared with housed people. Homeless individuals had higher CVD incidence in all three arterial territories than housed people.

conclusionCVD in homeless individuals has high prevalence, incidence, and 1-year mortality risk post-diagnosis with earlier onset, and high burden of risk factors. Inclusion health and social care strategies should reflect this high preventable and treatable burden, which is increasingly important in the current COVID-19 context.

Indexed as

Atrial FibrillationBrain IschemiaCardiovascular DiseasesCoronavirus InfectionsPandemicsPneumonia, ViralStrokeAngiotensinsBetacoronavirusCOVID-19Electronic Health RecordsHumansIncidencePrevalenceRisk FactorsSARS-CoV-2AngiotensinsCardiovascularCOVID-19Electronic health recordsHealth inequalitiesHomeless

Identifiers

PMID33205821
PMCPMC7672531
OpenAlexW3099945782

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.