Abdulkader Almosa

Background: While women are among the fastest-growing subgroups of the homeless population and have a higher prevalence of poverty than men, most studies of cardiovascular disease (CVD) risk in this vulnerable population are conducted primarily among men. We evaluated differences in CVD risk between men and women experiencing poverty and homelessness in West Texas, a medically underserved region. Methods: Data were collected from 152 adults (50% women) aged 30–74 years, who were seen at free health clinics. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. The Framingham risk algorithm was used to estimate the risk for incident CVD in the next 10 years. Results: The mean age of participants was 55.3 years. The prevalence of CVD risk factors was high among participants and tended to be similar between men and women: diabetes (34%), current smokers (47%), obesity (50%), and hypertension (83%). After controlling for demographic factors, behavior/lifestyle factors, and health conditions, the high (>20%) 10-year risk of CVD was two-fold higher among men (PR: 2.41, 95%CI: 1.75–3.32). While the association was consistent among men regardless of the number of comorbid conditions, among women, those with three or more comorbid conditions had an elevated 10-year risk for CVD compared to those with no comorbid conditions (PR: 11.68, 95%CI: 1.88–72.60, p interaction = 0.001). Conclusions: This study found that CVD risk was elevated among poor and homeless adults, with men having a higher risk than women. Comorbid conditions had a greater impact on women than men who were at high risk for CVD.

Little is known about the manifestation of cardiovascular diseases (CVD) among individuals with ocular cancer (OC), a population for whom reports on sex-based differences in survival remain inconsistent. We evaluated the occurrence of CVD mortality after the diagnosis of OC in the United States. We used data from 11,460 adults diagnosed with OC from 2000 to 2021 who were ≥18 years and were enrolled in the Surveillance, Epidemiology, and End Results program. We used competing risk models to estimate hazard ratios (HR) and 95% confidence intervals (CI). About 55% of adults were male, with uveal melanoma being the most common OC (72.1%). During a median follow-up of 5.4 years, 4561 deaths occurred, with 15% attributable to CVD. In models adjusted for sociodemographic and clinico-pathophysiological factors, male adults had elevated risk for CVD mortality (HR: 1.54, 95%CI: 1.31–1.81). The sex difference in CVD mortality was more prominent for adults diagnosed with OC before 65 years of age (HR: 2.15; 95%CI: 1.48–3.11). These associations remained largely unchanged in propensity score analysis. In this study of adults with OC, CVD deaths were higher among young and middle-aged males. Implementation of optimal cardiovascular health interventions after diagnosis of OC, especially among men, holds promise in enhancing survival in this population.