Sexual Minority Women and Cardiovascular Disease Risk: A population-based study

Heart disease is the number 1 killer of women and 1 in 3 women live with cardiovascular disease (CVD) in the US. Decades of research have informed us about the importance of CVD prevention. However, compared to heterosexual women (HW), sexual minority women (SMW) have been observed to have significantly greater patterns of CVD risk-enhancing behaviors, including elevated tobacco use, obesity, and alcohol consumption. Historically, CVD risk scores for this marginalized group have not been reported despite a growing literature pointing to their CVD risk. The current study used data from the National Health and Nutrition Examination Survey (NHANES) 2001-2008 to compare CVD risk and vascular age among 310 SMW and 5,543 HW. Using vascular age as an indicator of CVD risk, the difference between women's vascular age and chronological age was significantly (p=.033) larger for SMW compared to their HW counterparts. On average, the entire sample was 2.1 years older in vascular terms compared to their chronological age, but this difference increased to 4.4 years older among SMW. The relationship between SMW and increased vascular age did not change significantly after controlling for family history of cardiovascular disease; however, controlling for smoking status diminished the relationship and rendered it statistically insignificant (p=.28). With 40.25% of SMW indicating current smoking compared to 23.55% of HW (p<.001), the heightened CVD risk among SMW appears primarily driven by significant differences in smoking status.