Risk Factors for Cardiovascular Disease and Sexual Orientation: Women Enrolled in the ESTHER Study

Published research report that lesbians have higher rates of many risk factors associated with cardiovascular disease, including increased tobacco use and higher rates of obesity. However, reports also find that lesbian women are more likely to report engaging in leisure time physical activity and regular alcohol consumption, factors that may be cardioprotective. Our aim was to investigate the association between self-reported health behaviors, coupled with clinical exam data including biochemical indicators of risk for cardiovascular disease among women who participated in the ESTHER Project (Epidemiologic STudy of HEalth Risk in Women). The ESTHER Project (2003-2006) included 1084 women 35+ years of age, over half self-identified as lesbian (n= 504). Women completed extensive questionnaires and attended clinic sessions that included standardized measurements of anthropometrics and blood pressure. Blood samples were collected and analyzed for lipid profiles, insulin, glucose, and inflammatory markers. A Framingham CHD Risk Score Calculation was generated for each woman. Univariate analyses confirmed previous findings of differences between lesbian and heterosexual women with regard to body mass index, smoking, alcohol consumption and physical activity. No significant differences were found in lipid profiles, but lesbian women did have significantly higher C-reactive protein levels and elevated blood pressure, as well an overall greater percentage of women with excess risk using the Framingham Risk Score. These findings are among the first with biochemical measurements to confirm an elevated risk of cardiovascular disease among lesbian women, and provide support for targeted intervention messages and programs.