Program for the Study of LGBT Health, Columbia University School of Nursing, New York, NY, USA.
New York University Rory Meyers College of Nursing, New York, NY, USA.
Ethn Health. 2022 Apr;27(3):617-638. doi: 10.1080/13557858.2020.1740174. Epub 2020 Mar 11.
Sexual minorities face significant psychosocial stressors (such as discrimination and violence) that impact their health. Several studies indicate that sexual minority women (SMW) and bisexual men may be at highest risk for cardiovascular disease (CVD), but limited research has examined physiological CVD risk or racial/ethnic differences. This study sought to examine racial/ethnic differences in physiological risk factors for CVD among sexual minority and heterosexual adults.: We analyzed data from the National Health and Nutrition Examination Survey (2001-2016) using sex-stratified multiple linear regression models to estimate differences in physiological CVD risk. We compared sexual minorities (gay/lesbian, bisexual, 'not sure') to heterosexual participants first without regard to race/ethnicity. Then we compared sexual minorities by race/ethnicity to White heterosexual participants. The sample included 22,305 participants (ages 18-59). Lesbian women had higher body mass index (BMI) but lower total cholesterol than heterosexual women. Bisexual women had higher systolic blood pressure (SBP). Gay men had lower BMI and glycosylated hemoglobin (HbA1c) relative to heterosexual men. White and Black lesbian women and bisexual women of all races/ethnicities had higher BMI than White heterosexual women; Black bisexual women had higher SBP and HbA1c. Black sexual minority men had higher HbA1c relative to White heterosexual men. Latino 'not sure' men also had higher SBP, HbA1c, and total cholesterol than White heterosexual men. Given evidence of higher CVD risk in sexual minority people of color relative to White heterosexuals, there is a need for health promotion initiatives to address these disparities. Additional research that incorporates longitudinal designs and examines the influence of psychosocial stressors on CVD risk in sexual minorities is recommended. Findings have implications for clinical and policy efforts to promote the cardiovascular health of sexual minorities.
性少数群体面临着重大的心理社会压力源（如歧视和暴力），这些压力源会影响他们的健康。有几项研究表明，性少数群体女性（SMW）和双性恋男性可能面临最高的心血管疾病（CVD）风险，但有限的研究检查了生理 CVD 风险或种族/民族差异。本研究旨在研究性少数群体和异性恋成年人中 CVD 的生理风险因素的种族/民族差异：我们使用性别分层多元线性回归模型分析了国家健康和营养检查调查（2001-2016 年）的数据，以估计生理 CVD 风险的差异。我们首先比较了性少数群体（同性恋/女同性恋、双性恋、“不确定”）与异性恋参与者，而不考虑种族/民族。然后，我们比较了不同种族/民族的性少数群体与白种异性恋参与者。该样本包括 22,305 名参与者（年龄 18-59 岁）。女同性恋者的体重指数（BMI）较高，但总胆固醇低于异性恋女性。双性恋女性的收缩压（SBP）较高。与异性恋男性相比，男同性恋者的 BMI 和糖化血红蛋白（HbA1c）较低。白人和黑人性少数群体的女同性恋者和所有种族/民族的双性恋女性的 BMI 均高于白种异性恋女性；黑人性少数群体的双性恋女性的 SBP 和 HbA1c 较高。与白种异性恋男性相比，黑人性少数群体的男性的 HbA1c 较高。拉丁裔“不确定”男性的 SBP、HbA1c 和总胆固醇也高于白种异性恋男性。鉴于有色人种的性少数群体的 CVD 风险高于白种异性恋者的证据，需要采取健康促进措施来解决这些差异。建议进行纳入纵向设计的进一步研究，并检查心理社会压力源对性少数群体 CVD 风险的影响。这些发现对促进性少数群体心血管健康的临床和政策工作具有重要意义。
