Lesbian and bisexual women at higher risk of heart disease, study finds

Cardiologists should ask patients about their sexual orientation during heart checkups, researchers say.

The recommendation came from a study that found lesbian and bisexual women are at a higher risk of heart disease than their straight counterparts. Meanwhile, gay men were at a lower risk compared to heterosexual men of the same age.

The medics said knowing a patient’s sexuality could ‘help improve’ healthcare offered to patients and lead them to receive more advice on avoiding heart disease.

Asking about patients’ sexual orientation is not routine, but is more common in sexual health clinics where the type of sexual partner someone has can affect their risk of disease.

The above shows the heart health scores by group among men and women. It was calculated using the American Heart Association’s LE8 method, which takes into account factors including exercise levels, diet and smoking status

It is not clear why sexual minorities were at higher risk of heart disease, but discrimination and higher poverty rates may be behind the data. LGBT groups have long been known to face a higher risk of multiple health problems, including depression – a risk factor for heart problems.

Lead study author Dr Omar Deraz, a PhD candidate at the Universite Paris Cite in France, said: ‘Improving cultural competency and awareness of cardiovascular disease risk among sexual minority adults may help to improve conversations between doctors and patients about cardiovascular health, including prevention and management.

‘Understanding and overcoming barriers to health care access are essential to improve cardiovascular disease prevention and care in sexual minorities.’

In the study, researchers looked at 170,000 people who were about 46 years old and lived in France. 

Of the 91,000 who were women, 93 percent said they were heterosexual while 3.5 percent said they were bisexual and one percent identified as lesbian.

Of the 78,550 men, 90 percent said they were heterosexual, while 3.5 percent said they were bisexual and three percent said they were gay.

In both groups, about three percent of participants declined to answer.

Each participant was then asked about heart health factors, including diet, physical activity, smoking status, sleep, body mass index (BMI) and data from blood tests.

The figures were then used by scientists to calculate a score for their heart health using a method designed by the American Heart Association.

Results showed that, among women, those who were lesbian or bisexual had lower heart health scores than their straight peers.

But among women who had been pregnant, those who had a sexual minority status had better heart health scores. The reasons are not clear.

For men, those who identified as gay had better heart health scores than their straight peers.

The researchers suggested that people from sexual minorities may be at higher risk of heart health problems because of mental health problems.

These are at higher rates in the group, likely due to societal pressures, and can drive unhealthy coping behaviors, such as drinking more alcohol, smoking and a sedentary lifestyle.

LGBT people are also more likely to be living in poverty, data shows, which can lead to more unhealthy diets high in ultra-processed foods.

The above shows the heart health scores for participants based on the American Heart Association’s LS7 method. The LE8 looks at non-HDL cholesterol, while LS7 only considers total cholesterol.

But the better heart health scores in gay men may be due to lifestyle factors.

Studies have previously suggested that gay men are more likely to have better diets and are less likely to be overweight.

Dr Deraz added: ‘Although this data may not be fully applicable to other countries, it’s important research into a population that is grossly underrepresented in clinical and epidemiological studies.

‘To fully address discrimination and disparities that impact health, we must better recognize and understand the unique experiences of all individuals and populations including sexual minorities.’

The paper was published today in the Journal of the American Heart Association.

It comes after another study found in March that bisexual women were more likely to have heart disease than their straight peers.

Scientists warned that sexual orientation may be a previously unknown risk of cardiovascular problems.

They believe marginalization may have something to do with the finding, but accept that it is unusual.

Heightened risks were not recorded in gay women or homosexual or bi men in the study.