Women who identify as lesbian or bisexual may be at higher risk of heart disease. according to a new study by the American Heart Association (AHA).
Gay and bisexual men, on the other hand, typically have a lower risk of heart disease than men who identify as straight, the study authors found — as long as those gay and bisexual men don’t live in rural areas.
The first study of its kind published in the Journal of the American Heart Associationreveals the complex relationship between sexuality and the risk factors for cardiovascular disease, a broad category of health conditions that includes heart attacks, strokes, atherosclerosis (hardening of the arteries), heart failure and cardiac arrhythmias.
Researchers theorize that there could be a number of explanations for the differences in heart disease risk between heterosexuals and people who identify as gay or bisexual.
For example, previous studies suggest that gays and lesbians may be more likely to suffer from mental health problems and procrastinate on health care than heterosexuals.
“Given previous evidence, these results could be explained, at least in part, by living conditions such as poverty, deteriorated working conditions, mental health problems, discrimination, and/or poor past experiences in the health care system,” said the study’s lead author, Omar Deraz, a researcher and Ph.D . Candidate of the French National Institute of Health and Medical Research and the Integrative Epidemiology of Cardiovascular Diseases team of the Paris Center for Cardiovascular Research, in a press release.
The research team gained the insights by using the AHAs to examine health information for more than 169,400 adults across France, 54% of whom were women “Life’s Essential 8” Criteria that include factors such as diet, activity level, sleep patterns, blood pressure and cholesterol levels.
Dubbed the CONSTANCES study, the study began recruiting participants in 2012, and each participant underwent clinical assessments and laboratory testing at baseline and every four years thereafter through 2020.
The analysis found that women had better overall cardiovascular health than men, regardless of their sexual orientation. However, compared to straight women, the women who identified as lesbian or bisexual had poorer overall cardiovascular health.
Part of the difference may be due to increased exposure to healthcare professionals during pregnancy, although the small number of lesbians who reported ever having been pregnant complicates interpretation.
Conversely, gay and bisexual men had significantly better cardiovascular health than straight men when the gay men lived in urban areas.
Researchers hypothesized that gay men living in rural areas may be more exposed to stressors such as discrimination, sleep problems or other concerns that could impact their cardiovascular health.
The results confirm the results of other investigations.
In the National Health and Nutrition Examination Survey (NHANES) Bisexual women had poorer cardiovascular health According to a study published in February 2023, the results are higher than in heterosexual women, mainly due to cigarette smoking and a higher body mass index (BMI).
And in 2020 The AHA has identified a wide range of health stressors among sexual minorities, such as discrimination, violence, family rejection and, particularly among racial or ethnic minorities, higher rates of poverty, insecure housing and reduced access to health care.
The new research is qualified by including only residents of France, a relatively affluent country with universal health coverage, in the study population who self-identify as gay, bisexual, or straight.
“Although these data may not be fully applicable to other countries, this is important research on a population that is grossly underrepresented in clinical and epidemiological studies,” said Connie W. Tsao, MD, assistant professor of medicine at Harvard Medical School and treating staff cardiologist at Beth Israel Deaconess Medical Center in Boston, in a press release.
“To fully address discrimination and inequalities that affect health, we need to better recognize and understand the unique experiences of all individuals and populations, including sexual minorities,” Tsao added.