Top Things to Know: Assessing and Addressing Cardiovascular Health in LGBTQ Adults
Statement from the writing group: The writing group included scholars with extensive experience conducting research on the health of LGBTQ populations with many identifying as LGBTQ themselves.
- There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared to their heterosexual and/or non-transgender peers.
- The objectives of this statement are to: 1) present a conceptual model to elucidate potential mechanisms underlying cardiovascular health disparities in LGBTQ adults, 2) identify research gaps, and 3) provide suggestions for improving cardiovascular research and care of LGBTQ people.
- Cardiovascular health disparities in LGBTQ people are posited to be driven primarily by exposure to interpersonal and structural stressors (e.g., violence and discriminatory policies) across the lifespan.
- The statement reviews literature on LGBTQ disparities as it relates to the components of the American Heart Association’s Life’s Simple 7 (including tobacco use, physical activity, diet, BMI, blood pressure, glycemic status, and lipids).
- Differences in cardiovascular health metrics between sexual minority and heterosexual adults are more pronounced in studies that have used objective measures.
- There is limited understanding of the cardiovascular health of LGBTQ adults with multiple stigmatized identities (e.g., racial and ethnic minorities, low-income).
- Longitudinal research that examines social and clinical determinants of optimal cardiovascular health in LGBTQ adults is needed to identify psychosocial and behavioral targets for interventions.
- Clinicians and other health professionals need training on identifying LGBTQ health disparities and the proper assessment of sexual orientation and gender identity in healthcare settings.
- The inclusion of sexual orientation and gender identity measures in electronic health records provides an opportunity to leverage these data to examine cardiovascular health in LGBTQ adults.
- Content targeted specifically to LGBTQ health content should be incorporated in health professions curricula and LGBTQ-related accreditation and licensure requirements are needed for clinicians.
Citation
Caceres BA, Streed CG Jr, Corliss HL, Lloyd-Jones DM, Matthews PA, Mukherjee M, Poteat T, Rosendale N, Ross LM; on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Hypertension; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council. Assessing and addressing cardiovascular health in LGBTQ adults: a scientific statement from the American Heart Association [published online ahead of print October 8, 2020]. Circulation. doi: 10.1161/CIR.0000000000000914