Lesbian, gay, bisexual veterans at greater risk for cardiovascular disease

FOR IMMEDIATE RELEASE, November 7, 2024
Contact: Gina DiGravio, 617-358-7838, ginad@bu.edu

Lesbian, Gay, Bisexual Veterans at Greater Risk for Cardiovascular Disease

“Even when accounting for inequities in risk factors, sexual minority veterans continue to fair worse than heterosexual peers”

(Boston)—Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death among U.S. adults. Despite declining rates of ASCVD mortality, significant disparities across multiple social and demographic characteristics, such as race and income, persist.

In one of the first studies to examine cardiovascular risk factors and disease of the veteran population, researchers from Boston University Chobanian & Avedisian School of Medicine found that, as a group, sexual minority adults, lesbian, gay and bisexual (LGB), fared worse than their non-sexual minority peers.   

“With an increasing visibility and acceptance of this sexual minority population, and with projections indicating there will be upwards of seven million LGB adults over the age of 50 by 2030, assessing and addressing the cardiovascular health of LGB older adults remains a critical priority for LGB patients as well as clinicians, researchers and public health officials,” explains corresponding author Carl G. Streed, MD, MPH, FACP, FAHA, associate professor of medicine at the school.

Using data from the Veterans Healthcare Administration, the researchers identified 1,102,193 veterans who provided information on their sexual orientation. Of that group, 170,861 were classified as LGB. They then calculated sample statistics by sex and sexual orientation and used logistic regression analyses to assess associations between sexual orientation and the prevalence of atherosclerotic cardiovascular disease.

After adjusting for age, sex, race, and Hispanic ethnicity, LGB veterans had a 1.24 times greater risk of ASCVD versus non-LGB identified veterans. This association remained significant upon additional adjustment for ASCVD risk factors, substance use, anxiety and depression.  

According to the researchers, sexual minority males and females had a higher prevalence of smoking and alcohol use than their heterosexual peers. “These findings underscore that efforts to reduce tobacco use and aid cessation efforts remain a much-needed intervention for sexual minority persons to improve their health and wellbeing. Similarly, diagnoses of alcohol use disorders were higher among sexual minority males and females compared with their heterosexual peers. Alcohol and tobacco use remain common health concerns for sexual minority adults and are often cited as coping mechanisms in dealing with stress,” adds Streed.

These finding appear online in the Journal of the American Heart Association.

Funding for this research was provided by Boston University Chobanian and Avedisian School of Medicine Department of Medicine Career Investment Award, American Heart Association career development grant (AHA 20CDA35320148), National Heart, Lung, and Blood Institute career development grant (NHLBI 1K01HL151902-01A1), and Doris Duke Charitable Foundation (grant #2022061). Duncan reports salary support from the National Center for Advancing Translational Sciences, National Institutes of Health (KL2TR001996).

Caceres reports salary support from National Heart, Lung, and Blood Institute career development grant (NHLBI K01HL146965).Workman, O’Leary, Skanderson, and Goulet report salary support from the Veterans Affairs Health Services Research and Development Services (IIR 18-035).

Note to editor:

The views expressed in this article are those of the authors and do not necessarily reflect the position or policies of the Department of Veterans Affairs. Streed reports receiving consulting fees from EverlyWell, L’Oreal, the Texas Health Institute, the Research Institute for Gender Therapeutics, and the US Department of Justice unrelated to this work.