Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA.
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA.
LGBT Health. 2021 Feb-Mar;8(2):91-106. doi: 10.1089/lgbt.2019.0121. Epub 2021 Jan 12.
The aim was to review and summarize reports on three measures of elevated blood pressure (BP) among sexual minority men (encompassing men who have sex with men [MSM] and both men and women [MSMW]), using men who have sex with women (MSW) as the reference population. Crude prevalence rates were calculated, and a meta-analysis was conducted to summarize the likelihood of elevated BP history, antihypertensive medication use, and elevated BP above a cutoff value, as well as the mean differences (MDs) in systolic BP (SBP) and diastolic BP (DBP) measurements. We used random effects to generate estimates with their respective 95% confidence intervals (CIs); alpha was set at 0.05. Studies ( = 20) were published between 2007 and 2018, mostly in the United States. The likelihood of elevated BP history was not statistically significantly higher among sexual minority men, except when the measurement of sexual orientation was multidimensional (odds ratio [OR] 1.41, 95% CI 1.12-1.78). The likelihood of antihypertensive medication use was only statistically significantly higher for men who self-identified as MSMW (OR 1.44, 95% CI 1.11-1.85). When elevated BP was determined through a set cutoff, MSM were less likely (OR 0.34, 95% CI 0.16-0.70), whereas MSMW were more likely (OR 2.25, 95% CI 1.54-3.28) to have elevated BP. Although there were no statistically significant findings in the MD for SBP, the MD for DBP among sexual minority men was significantly higher (MD 1.46, 95% CI 1.38-1.55 mmHg) than among the MSW comparison group. Sexual minority men classified using a multidimensional approach to sexual orientation had a significantly higher likelihood of elevated BP history. Using BP cutoffs yielded opposite effects in MSM and MSMW. Although SBP was not different compared to MSW, DBP-a marker of hypertension at earlier ages-was elevated among sexual minority men.
目的是综述和总结关于性少数群体男性（包括男男性行为者[MSM]和男女两性[MSMW]）三种血压升高指标的报告，以与女男性行为者（MSW）作为参考人群。计算了粗患病率，并进行了荟萃分析，以总结血压升高史、使用抗高血压药物和血压超过临界值的可能性，以及收缩压（SBP）和舒张压（DBP）测量值的平均差异（MDs）。我们使用随机效应生成具有各自 95%置信区间（CI）的估计值；alpha 值设定为 0.05。研究（ = 20）发表于 2007 年至 2018 年之间，主要来自美国。除了在多维测量性取向时，性少数群体男性血压升高史的可能性没有统计学意义上的显著升高（比值比[OR] 1.41，95% CI 1.12-1.78）。只有自我认同为 MSMW 的男性使用抗高血压药物的可能性具有统计学意义上的显著升高（OR 1.44，95% CI 1.11-1.85）。当通过设定的临界值确定血压升高时，MSM 不太可能（OR 0.34，95% CI 0.16-0.70），而 MSMW 更有可能（OR 2.25，95% CI 1.54-3.28）出现血压升高。尽管 SBP 的 MD 没有统计学意义上的发现，但性少数群体男性的 DBP MD 显著更高（MD 1.46，95% CI 1.38-1.55 毫米汞柱），高于 MSW 对照组。使用多维方法对性取向进行分类的性少数群体男性血压升高史的可能性显著更高。使用血压临界值对 MSM 和 MSMW 产生了相反的影响。尽管与 MSW 相比 SBP 没有差异，但 DBP——更年轻的高血压标志物——在性少数群体男性中升高。
