Online Program

Rates and predictors of uncontrolled hypertension among hypertensive adults using New York City shelter-based clinics

Monday, November 2, 2015

Ramin Asgary, MD, MPH, Dept of Medicine, Weill Cornell College of Medicine and New York University School of Medicine, New York, NY
Blanca Sckell, MD, MPH, Community Medicine Program, Lutheran Family Health Centers, Brooklyn, NY
Analena Alcabes, BS, Medicine, New York University School of Medicine, New York, NY
Ramesh Naderi, MD, NYU School of Medicine, New York
Antoinette Schoenthaler, EdD, MA, Department of Population Health, New York University Langone Medical Center, New York, NY
Gbenga Ogedegbe, MD, MS, MPH, FACP, Department of Population Health, New York University Langone Medical Center, New York, NY
Hypertension is one the most common conditions among millions of homeless Americans. We determined the rates, predictors, and barriers to blood pressure (BP) control among homeless and domicile hypertensive patients from 10 New York City shelter-based clinics. BP measurements, sociodemographics, and factors associated with homelessness and hypertension were extracted from medical records of a random sample of hypertensive patients (n=210) in 2014. The majority of patients were African American or Hispanic; 24.8% were female and 84.3 % homeless (mean|=|3.07 years; SD|=|5.04 years). Compared to domicile patients, homeless were younger, less insured, and more likely a current smoker and alcohol abuser. Homeless and domicile patients had 40.1% and 33.3% uncontrolled BP, respectively (P|=|.29); stage II BP was 15% and 9%, respectively (P|=|.27). Homeless hypertensive patients with diabetes or multiple chronic diseases had better BP control (P|<|.01). In logistic regression, age, race or ethnicity, substance or alcohol abuse were not associated with inadequate BP control but mental health and lack of insurance were (P|<|.05). We propose comprehensive approaches to address psychosocial issues and lack of insurance that complicate BP control. Improving adherence, health education, and life style modifications using mHealth strategies in this mobile population may be considered.

Learning Areas:

Advocacy for health and health education
Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Evaluate the rates and predictors of uncontrolled BP among hypertensive homeless using New York City’s shelter-based clinics Discuss interventions aimed at improving BP control among hypertensive homeless

Keyword(s): Homelessness, Hypertension

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have designed and conducted this study, and analyzed data and prepared the abstract. I have extensive experience in working with and researching vulnerable population including the homeless and in health disparities research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.