Caceres Billy A, Sharma Yashika, Doan Danny, Ravindranath Rohith, Nguyen Vince, Ensari Ipek, Belloir Joseph, Lim Yu Zheng, Cook Stephanie
Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, 560 West 168th Street, Room 603, New York, NY 10032, United States.
University of Connecticut School of Nursing, Storrs, CT 06269, United States.
Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaaf032.
Cardiovascular health (CVH) disparities have been documented among sexual minority adults, yet prior research has focused on individual CVH metrics. We sought to examine sexual identity differences in CVH using the American Heart Association's composite measure of ideal CVH, which provides a more comprehensive assessment of future CVD risk.
Data from the All of Us Research Program were analyzed. Sexual identity was categorized as heterosexual, gay/lesbian, bisexual, or other. Individual CVH health metrics and cumulative ideal CVH (range 0-100) were assessed. We ran sex-stratified multiple linear regression models to estimate differences across individual CVH metrics and cumulative ideal CVH between sexual minority and heterosexual adults. We also explored differences in CVH across racial/ethnic and age groups.
The sample included 11 047 cisgender adults with a mean age of 61.1 years (± 13.85); 80% were non-Hispanic White. Lesbian women, gay men, and bisexual women reported greater nicotine exposure than their heterosexual counterparts. Compared to heterosexual men, gay men (B [95% CI] = -8.95 [-14.50, -3.39]) had worse physical activity scores. Gay men also had better body mass index scores than heterosexual men (B [95% CI] = 3.21 [0.09, 6.33]). Bisexual women and men had lower cumulative ideal CVH scores than heterosexual adults. Exploratory analyses revealed several differences in individual CVH metrics and cumulative ideal CVH across racial/ethnic and age groups.
Clinical interventions to improve the CVH of bisexual adults are needed. Findings can inform the design of interventions that are tailored for specific subgroups of sexual minority adults.
性少数成年人中存在心血管健康（CVH）差异，然而先前的研究主要集中在个体CVH指标上。我们试图使用美国心脏协会的理想CVH综合指标来研究性取向在CVH方面的差异，该指标能更全面地评估未来心血管疾病（CVD）风险。
对“我们所有人”研究项目的数据进行分析。性取向分为异性恋、男同性恋/女同性恋、双性恋或其他。评估个体CVH健康指标和累积理想CVH（范围为0 - 100）。我们进行了按性别分层的多元线性回归模型，以估计性少数成年人与异性恋成年人在个体CVH指标和累积理想CVH方面的差异。我们还探讨了不同种族/族裔和年龄组在CVH方面的差异。
样本包括11047名顺性别成年人，平均年龄为61.1岁（±13.85）；80%为非西班牙裔白人。女同性恋者、男同性恋者和双性恋女性报告的尼古丁暴露量高于其异性恋同龄人。与异性恋男性相比，男同性恋者的身体活动得分更差（B [95% CI] = -8.95 [-14.50, -3.39]）。男同性恋者的体重指数得分也高于异性恋男性（B [95% CI] = 3.21 [0.09, 6.33]）。双性恋女性和男性的累积理想CVH得分低于异性恋成年人。探索性分析揭示了不同种族/族裔和年龄组在个体CVH指标和累积理想CVH方面的若干差异。
需要采取临床干预措施来改善双性恋成年人的CVH。研究结果可为针对性少数成年人特定亚组设计干预措施提供参考。
