Optimal CV health varies by sex, sexual identity in lesbian, gay, bisexual individuals
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Rates of optimal CV health as determined by the American Heart Association’s Life’s Essential 8 among gay, lesbian and bisexual individuals vary by sex and sexual identity, researchers reported.
“The purpose of this cross-sectional study was to examine sexual identity differences in CV health scores among adults in the U.S. using data from the National Health and Nutrition Examination Survey,” Billy A. Caceres, PhD, RN, assistant professor at Columbia University School of Nursing and affiliated investigator of the Center for Sexual and Gender Minority Health Research, and colleagues wrote. “We hypothesized that gay male individuals would have better CV health profiles and that all other groups of sexual minority adults would have worse CV health profiles than their heterosexual counterparts of the same sex.”
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Caceres and colleagues conducted a cross-sectional study of population-based data from NHANES and included noninstitutional 12,180 adults (mean age, 39.6 years; 50.5% men) aged 18 to 59 years who were not pregnant at the time of interview and free from atherosclerotic CVD or HF at baseline.
Information regarding sexual identity was collected using NHANES questionnaires between 2007 and 2014. Participants were asked, “Do you think of yourself as ... ?” and response options combined sexual identity and attraction, according to the study.
The main outcome was ideal CV health score as assessed using the AHA’s Life’s Essential 8. Participants received a score of 0 to 100 for each metric, with a higher score representing better CV health.
The researchers reported that women who self-reported as lesbian (beta = 17.21; 95% CI, 31.98 to 2.44) and bisexual (beta = 13.76; 95% CI, 20.54 to 6.99) had lower nicotine scores compared with heterosexual women.
Bisexual women respondents also less favorable BMI scores (beta = 7.47; 95% CI, 12.89 to 1.97) and lower cumulative CV health scores (beta = 2.59; 95% CI, 4.84 to 0.33) compared with heterosexual women, according to the study.
The researchers observed that gay men had lower nicotine scores compared with heterosexual men (beta = 11.43; 95% CI, 21.87 to 0.99); however, gay men had better diet (beta = 9.65; 95% CI, 2.38-16.92), BMI (beta = 9.75; 95% CI, 1.25-18.25) and glycemic status scores (beta = 5.28; 95% CI, 0.59-9.97) than heterosexual men.
Compared with heterosexual men, bisexual men were more likely to report a diagnosis of hypertension (adjusted OR = 1.98; 95% CI, 1.1-3.56) and antihypertensive medication use (aOR = 2.2; 95% CI, 1.12-4.32), according to the study.
The researchers observed no differences in CV health among participants who reported their sexual identity as something else compared with heterosexual, according to the study.
“Bisexual female individuals and gay/lesbian adults had greater nicotine exposure than heterosexual adults,” the researchers wrote. “Bisexual female individuals had worse cumulative CV health scores than heterosexual female individuals, whereas gay male individuals generally had better CV health than heterosexual male individuals. There is a need for tailored interventions to improve the CV health of sexual minority individuals, particularly bisexual female individuals. Investigators should conduct longitudinal research that examines social determinants that may explain the sexual identity differences observed in this study.”
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