Cardiovascular Disease Disparities in Sexual Minority Adults: An Examination of the Behavioral Risk Factor Surveillance System (2014-2016)

Abstract

Purpose: Investigate sexual orientation differences in cardiovascular disease risk and cardiovascular disease. Design: Cross-sectional. Setting: The 2014 to 2016 Behavioral Risk Factor Surveillance System. Participants: A total of 395 154 participants. Measures: The exposure measure was sexual orientation. Self-report of cardiovascular disease risk factors and cardiovascular disease was assessed. Analysis: Sex-stratified logistic regression analyses to examine sexual orientation differences in cardiovascular disease risk and cardiovascular disease (heterosexuals = reference group). Results: Sexual minority men reported higher rates of mental distress (gay adjusted odds ratio [AOR]: 1.59; bisexual AOR: 1.88) and lifetime depression (gay AOR: 2.48; bisexual: AOR 2.67). Gay men reported higher rates of current smoking (AOR: 1.28), but lower rates of obesity (AOR: 0.82) compared to heterosexual men. Sexual minority women reported higher rates of several cardiovascular risk factors including mental distress (lesbian AOR: 1.37; bisexual AOR: 2.33), lifetime depression (lesbian AOR: 1.96; bisexual AOR: 3.26), current smoking (lesbian AOR: 1.65; bisexual AOR: 1.29), heavy drinking (lesbian AOR: 2.01; bisexual AOR: 2.04), and obesity (lesbian AOR: 1.50; bisexual AOR: 1.29), but were more likely to exercise than heterosexual women (lesbian AOR: 1.34; bisexual AOR: 1.24). Lesbian women reported lower rates of heart attack (AOR: 0.62), but bisexual women had higher rates of stroke than heterosexual women (AOR: 1.46). Conclusions: Findings can inform the development of prevention efforts to reduce cardiovascular disease risk in sexual minorities.