Effect of a housing intervention on major cardiovascular events among homeless adults with mental illness

Homelessness is associated with excess cardiovascular morbidity and mortality. This study reports on the long-term effects of a Canadian housing first initiative, compared to treatment as usual, on major cardiovascular events among adults experiencing homelessness and mental illness. Over the 7-year follow-up period, 34 of 527 participants (6.5%) experienced at least one cardiovascular event. There was no significant difference in the incidence of cardiac events between the housing first and treatment as usual groups. Strengths of this study include its randomized controlled design and use of comprehensive administrative databases to ascertain cardiac events. However, a relatively small sample size limited power to determine whether housing reduced the incidence of major adverse cardiovascular events. Notwithstanding these limitations, additional interventions aimed at improving cardiovascular outcomes are likely to be beneficial for patients undergoing a housing intervention.