Study: Women Identifying as Lesbian, Bisexual More Likely to Have Worse Cardiovascular Health

Women who identify as lesbian or bisexual are less likely to have ideal cardiovascular (CV) health, according to a recent study published in the Journal of the American Heart Association. This is the first study to evaluate CV health disparities among people who identified as part of a sexual minority group—lesbian, gay, bisexual, or heterosexual in the context of this study.

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“Improving cultural competency and awareness of cardiovascular disease risk among sexual minority adults may help to improve conversations between doctors and patients about cardiovascular health, including prevention and management,” said lead study author Omar Deraz, DMD, MPh, PhD-candidate affiliated with Université Paris Cité, Inserm, and the Paris Cardiovascular Research Center, in a recent press release.

Investigators aimed to identify possible differences in Life’s Essential 8 CV health scores in sexual minority individuals compared to heterosexual individuals. Life’s Essential 8 is an updated version of Life’s Simple 7, a series of metrics for ideal CV health that includes healthy diet, regular physical activity, no smoking, healthy weight, and normal blood sugar, cholesterol, and blood pressure levels (Life’s Essential 8 added healthy sleep).

“Improving these metrics is a great opportunity to prevent heart problems before they happen,” Deraz said in the press release.

The team analyzed health data of nearly 170,000 adults in France who had participated in the CONSTANCES (CONSulTANts des Centres d’Examens de Santé) study, designed to find risk factors of chronic disease and aging—participants did not have CV disease (CVD). CONSTANCES included approximately 91,000 women (93% identified as heterosexual; 3.5% bisexual; less than 1% lesbian), and 78,500 men (90% identified as heterosexual; 3.5% bisexual; 3% gay).

Women who are lesbian or bisexual had significantly worse CV health scores than heterosexual women, according to Life’s Essential 8 metrics. In addition, they had a lower score for healthy diet or healthy blood pressure level compared to women who are heterosexual. Women who are bisexual did have higher scores for healthy diet, and women who are lesbian had higher CV scores than women who are heterosexual and pregnant.

Conversely, a higher proportion of gay and bisexual men had ideal cardiovascular health scores compared to heterosexual men—although not sexual minority men living in rural areas.

The study findings may not be generalizable to lower-income countries without universal health care insurance. In addition, the study focused solely on CV health among sexual minority population, but does not include patients who identified as transgender.

Those who identify as sexual minorities are also more likely to be younger, self-employed, have higher education, live without a partner, live in poverty in urban areas, and have more patterns of drinking excess alcohol compared to people who are heterosexual. Further, they have more reports of mental health conditions and take more prescriptions for depression compared to heterosexual adults, according to the study.

“Understanding and overcoming barriers to health care access are essential to improve cardiovascular disease prevention and care in sexual minorities,” Deraz said in the press release.

“We are hopeful that studies like this one will help to fill this gap in our knowledge about cardiovascular health among sexual minority populations, which is essential to the American Heart Association’s mission to improve cardiovascular health equity for all people,” said Connie W. Tsao, MD, MPh, FAHA, an assistant professor of medicine at Harvard Medical School and attending staff cardiologist at Beth Israel Deaconess Medical Center in Boston, in the press release.

Reference

American Heart Association. Lesbian, bisexual women more likely to have worse heart health than heterosexual women. May 17, 2023. Accessed on May 17, 2023. https://www.eurekalert.org/news-releases/989079