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A systematic review of cardiovascular disease in sexual minorities

Author

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  • Caceres, B.A.
  • Brody, A.
  • Luscombe, R.E.
  • Primiano, J.E.
  • Marusca, P.
  • Sitts, E.M.
  • Chyun, D.

Abstract

Background: Mental health and HIV disparities are well documented among sexual minorities, but there is a dearth of research on other chronic conditions. Cardiovascular disease remains the leading cause of death worldwide. Although sexual minorities have high rates of several modifiable risk factors for cardiovascular disease (including stress, tobacco use, and alcohol consumption), there is a paucity of research in this area. Objectives: In this systematic review, we synthesized and critiqued the existing evidence on cardiovascular disease among sexual minority adults. Search Methods: We conducted a thorough literature search of 6 electronic databases for studies published between January 1985 and December 2015 that compared cardiovascular disease risk or prevalence between sexual minority and heterosexual adults. Selection Criteria: We included peer-reviewed English-language studies that compared cardiovascular disease risk or diagnoses between sexual minority and heterosexual individuals older than 18 years. We excluded reviews, case studies, and gray literature. A total of 31 studies met inclusion criteria. Data Collection and Analysis: At least 2 authors independently abstracted data from each study. We performed quality assessment of retrieved studies using the Crowe Critical Appraisal Tool. Main Results: Sexual minority women exhibited greater cardiovascular disease risk related to tobacco use, alcohol consumption, illicit drug use, poor mental health, and body mass index, whereas sexual minority men experienced excess risk related to tobacco use, illicit drug use, and poor mental health. We identified several limitations in the extant literature. The majority of included studies were crosssectional analyses that used self-reported measures of cardiovascular disease. Even though we observed elevated cardiovascular disease risk, we found few differences in cardiovascular disease diagnoses (including hypertension, diabetes, and high cholesterol). Overall, 23 of the 26 studies that examined cardiovascular disease diagnoses used subjective measures. Only 7 studies used a combination of biomarkers and self-report measures to establish cardiovascular disease risk and diagnoses. Authors' Conclusions: Social conditions appear to exert a negative effect on cardiovascular disease risk among sexual minorities. Although we found few differences in cardiovascular disease diagnoses, we identified an elevated risk for cardiovascular disease in both sexual minority men and women. There is a need for research that incorporates subjective and objective measures of cardiovascular disease risk. Public Health Implications: Cardiovascular disease is a major health concern for clinicians, public health practitioners, and policymakers. This systematic review supports the need for culturally appropriate interventions that address cardiovascular disease risk in sexual minority adults. ((The full article is available online.

Suggested Citation

  • Caceres, B.A. & Brody, A. & Luscombe, R.E. & Primiano, J.E. & Marusca, P. & Sitts, E.M. & Chyun, D., 2017. "A systematic review of cardiovascular disease in sexual minorities," American Journal of Public Health, American Public Health Association, vol. 107(4), pages 13-21.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2016.303630_4
    DOI: 10.2105/AJPH.2016.303630
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    Cited by:

    1. Angela Matijczak & Jennifer W. Applebaum & Shanna K. Kattari & Shelby E. McDonald, 2021. "Social Support and Attachment to Pets Moderate the Association between Sexual and Gender Minority Status and the Likelihood of Delaying or Avoiding COVID-19 Testing," Social Sciences, MDPI, vol. 10(8), pages 1-15, August.
    2. Kelly Horn & James A. Swartz, 2019. "A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance among Women: Results from a National U.S. Survey," IJERPH, MDPI, vol. 16(8), pages 1-14, April.
    3. Alexa Solazzo & Bridget Gorman & Justin Denney, 2020. "Does Sexual Orientation Complicate the Relationship Between Marital Status and Gender With Self-rated Health and Cardiovascular Disease?," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 599-626, April.
    4. Marius Baranauskas & Ingrida Kupčiūnaitė & Rimantas Stukas, 2022. "Psychoactive Substance Effect on Mental Health and Well-Being Focusing on Student-Aged Lithuanian Cohort of Sexual Minorities," Sustainability, MDPI, vol. 14(20), pages 1-16, October.
    5. Nora Gottlieb & Conny Püschmann & Fabian Stenzinger & Julia Koelber & Laurette Rasch & Martha Koppelow & Razan Al Munjid, 2020. "Health and Healthcare Utilization among Asylum-Seekers from Berlin’s LGBTIQ Shelter: Preliminary Results of a Survey," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    6. Kasey D. Klimo & Jessica Walls Wilson & Charlotte Farewell & Rose Grace Grose & Jini E. Puma & Danielle Brittain & Lauren B. Shomaker & Kelley Quirk, 2024. "A Pilot and Feasibility Study on a Mindfulness-Based Intervention Adapted for LGBTQ+ Adolescents," IJERPH, MDPI, vol. 21(10), pages 1-18, October.
    7. Yachao Li & Bo Yang & Bryan Chen, 2021. "LGB Tobacco Control: Do Health Belief Model Constructs Predict Tobacco Use Intentions Differently between LGB and Heterosexual Individuals?," IJERPH, MDPI, vol. 18(13), pages 1-12, June.
    8. Neeru Gupta & Samuel R. Cookson, 2023. "Evaluation of Survey Nonresponse in Measuring Cardiometabolic Health Risk Factors and Outcomes among Sexual Minority Populations: A National Data Linkage Analysis," IJERPH, MDPI, vol. 20(7), pages 1-11, March.
    9. Lei, Man-Kit & Berg, Mark T. & Simons, Ronald L. & Simons, Leslie G. & Beach, Steven R.H., 2020. "Childhood adversity and cardiovascular disease risk: An appraisal of recall methods with a focus on stress-buffering processes in childhood and adulthood," Social Science & Medicine, Elsevier, vol. 246(C).
    10. Scott, Darius, 2022. "Uncaring landscapes and HIV peer support in the rural Southern United States," Social Science & Medicine, Elsevier, vol. 292(C).
    11. Magdalena Mijas & Karolina Koziara & Andrzej Galbarczyk & Grazyna Jasienska, 2021. "Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland," IJERPH, MDPI, vol. 18(3), pages 1-12, January.

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