Sexual orientation differences in modifiable risk factors for cardiovascular disease and cardiovascular disease diagnoses in men

Billy A. Caceres, Abraham Brody, Perry N. Halkitis, Caroline Dorsen, Gary Yu, Deborah Chyun

Research output: Contribution to journalArticle

Abstract

Purpose: Despite higher rates of modifiable risk factors for cardiovascular disease (CVD) in gay and bisexual men, few studies have examined sexual orientation differences in CVD among men. The purpose of this study was to examine sexual orientation differences in modifiable risk factors for CVD and CVD diagnoses in men. Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation was performed for missing values. Differences across four distinct groups were analyzed: gay-identified men, bisexual-identified men, heterosexual-identified men who have sex with men (MSM), and heterosexual-identified men who denied same-sex behavior (categorized as exclusively heterosexual). Multiple logistic regression models were run with exclusively heterosexual men as the reference group. Results: The analytic sample consisted of 7731 men. No differences between heterosexual-identified MSM and exclusively heterosexual men were observed. Few differences in health behaviors were noted, except that, compared to exclusively heterosexual men, gay-identified men reported lower binge drinking (adjusted odds ratio [AOR] 0.58, 95% confidence interval [CI] = 0.37-0.85). Bisexual-identified men had higher rates of mental distress (AOR 2.39, 95% CI = 1.46-3.90), obesity (AOR 1.69, 95% CI = 1.02-2.72), elevated blood pressure (AOR 2.30, 95% CI = 1.43-3.70), and glycosylated hemoglobin (AOR 3.01, 95% CI = 1.38-6.59) relative to exclusively heterosexual men. Conclusions: Gay-identified and heterosexual-identified MSM demonstrated similar CVD risk to exclusively heterosexual men, whereas bisexual-identified men had elevations in several risk factors. Future directions for sexual minority health research in this area and the need for CVD and mental health screenings, particularly in bisexual-identified men, are highlighted.

Original languageEnglish (US)
Pages (from-to)284-294
Number of pages11
JournalLGBT Health
Volume5
Issue number5
DOIs
StatePublished - Jul 1 2018

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Sexual Behavior
Cardiovascular Diseases
Heterosexuality
Odds Ratio
Confidence Intervals
Minority Health
Logistic Models
Sexual Minorities
Binge Drinking
Nutrition Surveys
Reproductive Health
Health Behavior
Glycosylated Hemoglobin A

Keywords

  • cardiovascular disease
  • health promotion
  • mental health
  • sexual minorities
  • stress

ASJC Scopus subject areas

  • Dermatology
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Urology

Cite this

Sexual orientation differences in modifiable risk factors for cardiovascular disease and cardiovascular disease diagnoses in men. / Caceres, Billy A.; Brody, Abraham; Halkitis, Perry N.; Dorsen, Caroline; Yu, Gary; Chyun, Deborah.

In: LGBT Health, Vol. 5, No. 5, 01.07.2018, p. 284-294.

Research output: Contribution to journalArticle

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abstract = "Purpose: Despite higher rates of modifiable risk factors for cardiovascular disease (CVD) in gay and bisexual men, few studies have examined sexual orientation differences in CVD among men. The purpose of this study was to examine sexual orientation differences in modifiable risk factors for CVD and CVD diagnoses in men. Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation was performed for missing values. Differences across four distinct groups were analyzed: gay-identified men, bisexual-identified men, heterosexual-identified men who have sex with men (MSM), and heterosexual-identified men who denied same-sex behavior (categorized as exclusively heterosexual). Multiple logistic regression models were run with exclusively heterosexual men as the reference group. Results: The analytic sample consisted of 7731 men. No differences between heterosexual-identified MSM and exclusively heterosexual men were observed. Few differences in health behaviors were noted, except that, compared to exclusively heterosexual men, gay-identified men reported lower binge drinking (adjusted odds ratio [AOR] 0.58, 95{\%} confidence interval [CI] = 0.37-0.85). Bisexual-identified men had higher rates of mental distress (AOR 2.39, 95{\%} CI = 1.46-3.90), obesity (AOR 1.69, 95{\%} CI = 1.02-2.72), elevated blood pressure (AOR 2.30, 95{\%} CI = 1.43-3.70), and glycosylated hemoglobin (AOR 3.01, 95{\%} CI = 1.38-6.59) relative to exclusively heterosexual men. Conclusions: Gay-identified and heterosexual-identified MSM demonstrated similar CVD risk to exclusively heterosexual men, whereas bisexual-identified men had elevations in several risk factors. Future directions for sexual minority health research in this area and the need for CVD and mental health screenings, particularly in bisexual-identified men, are highlighted.",
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