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Differences in Hypertension by Sexual Orientation Among U.S. Young Adults

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Abstract

Using a nationally representative data set, this study provides the first estimates of differences in hypertension by sexual orientation using objective measures of systolic and diastolic blood pressure. Logistic regressions showed that there were no differences in hypertensive risk between mostly heterosexual/bisexual identified-respondents and heterosexual-identified respondents among both men and women. Gay men, however, are almost twice as likely (odds ratio = 1.92, p < .01) to be hypertensive compared to heterosexual men. The elevated risk is not explained by measures of minority stress, nor by cardiovascular disease risk factors such as smoking, alcohol use, drug use, BMI, or physical activity. No differences in hypertension risk by sexual orientation were detected among female respondents. The results suggest that gay men face an excess risk for hypertension compared to heterosexual men that is not explained by differences in measured health behaviors.

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Abbreviations

CVD:

Cardiovascular disease

OR:

Odds ratio

CI:

Confidence interval

References

  1. Center for Disease Control. (2011). Vital signs: Prevalence, treatment, and control of hypertension—United States, 1999–2002 and 2005–2008. Morbidity Mortality Weekly Report, 60, 103–108.

    Google Scholar 

  2. Muntner, P., He, J., Cutler, J. A., et al. (2004). Trends in blood pressure among children and adolescents. Journal of the American Medical Association, 291, 2107–2113.

    Article  PubMed  CAS  Google Scholar 

  3. Brummett, B. H., Babyak, M. A., Siegler, I. C., et al. (2011). Systolic blood pressure, socioeconomic status, and biobehavioral risk factors in a Nationally Representative US Young Adults Sample. Hypertension (published online ahead of print August 2012). doi:10.1161/HYPERTENSIONAHA.111.171272.

  4. Richardson, L. J., Hussey, J. M., & Strutz, K. L. (2011). Origins of disparities in cardiovascular disease: Birth weight, body mass index, and young adult systolic blood pressure in the National Longitudinal Study of Adolescent Health. Annals of Epidemiology, 21, 598–607.

    Article  PubMed  Google Scholar 

  5. U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion (US DHHS). (2011). Healthy people 2020 topics and objectives: Lesbian, gay, bisexual, and transgender health. doi:http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25.

  6. Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender (LGBT) people: Building a foundation for better understanding. Washington, DC: National Academies Press.

  7. Carey, J. W., Mejia, R., Bingham, T., et al. (2008). Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among males who have sex with males in Chicago and Los Angeles. AIDS and Behavior, 13, 1084–1096.

    Article  PubMed  Google Scholar 

  8. Gruskin, E. P., Greenwood, G. L., Matevia, M., et al. (2007). Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California. American Journal of Public Health, 97, 1496–1502.

    Article  PubMed  Google Scholar 

  9. Harawa, N. T., Williams, J. K., Ramamurthi, H. C., et al. (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American males who have sex with males. Archives of Sexual Behavior, 37, 748–762.

    Article  PubMed  Google Scholar 

  10. Lee, J. G. L., Griffin, G. K., & Melvin, C. L. (2009). Tobacco use among sexual minorities in the USA, 1987 to May 2007: A systematic review. Tobacco Control, 18, 275–282.

    Article  PubMed  CAS  Google Scholar 

  11. Kaye, S., McKetin, R., Duflou, J., & Darke, S. (2007). Methamphetamine and cardiovascular pathology: A review of the evidence. Addiction, 102, 1204–1211.

    Article  PubMed  Google Scholar 

  12. Mahmud, A., & Feely, J. (2003). Effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension, 41, 183–187.

    Article  PubMed  CAS  Google Scholar 

  13. Ockene, I. S., & Miller, N. H. (1997). Cigarette smoking, cardiovascular disease, and stroke: A statement for healthcare professionals from the American Heart Association. Circulation, 96, 3243–3247.

    Article  PubMed  CAS  Google Scholar 

  14. Ash, M. A., & Badgett, M. V. (2006). Separate and unequal: The effect of unequal access to employment-based health insurance on same-sex and unmarried different-sex couples. Contemporary Economic Policy, 24, 582–599.

    Article  Google Scholar 

  15. Heck, J. E., Sell, R. L., & Gorin, S. S. (2006). Health care access among individuals involved in same-sex relationships. American Journal of Public Health, 96, 1111–1118.

    Article  PubMed  Google Scholar 

  16. Jowett, A., & Peel, E. (2009). Chronic illness in non-heterosexual contexts: An online survey of experiences. Feminism & Psychology, 19, 454–474.

    Article  Google Scholar 

  17. Wolitski, R. J., Stall, R., & Valdiserri, R. O. (2008). Unequal opportunity: Health disparities affecting gay and bisexual males in the United States. Oxford, UK: Oxford University Press.

    Google Scholar 

  18. Borrell, L. N., Kiefe, C. I., Williams, D. R., et al. (2006). Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study. Social Science and Medicine, 63, 1415–1427.

    Article  PubMed  Google Scholar 

  19. McClure, H. H., Martinez, C. R., Snodgrass, J. J., et al. (2010). Discrimination-related stress, blood pressure and Epstein–Barr virus antibodies among Latin American immigrants in Oregon, U.S. Journal of Biosocial Science, 42, 433–461.

    Article  PubMed  Google Scholar 

  20. Thoits, P. A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51, S41–S53.

    Article  PubMed  Google Scholar 

  21. Ohlin, B., Nilsson, P. M., Nilsson, J. A., & Berglund, G. (2004). Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men. European Heart Journal, 25, 867–873.

    Article  PubMed  CAS  Google Scholar 

  22. Ryan, A. M., Gee, G. C., & Laflamme, D. F. (2006). The association between self-reported discrimination, physical health, and blood pressure: Findings from African Americans, black immigrants, and Latino immigrants in New Hampshire. Journal of Health Care for the Poor and Underserved, 17(2), 116–132.

    Google Scholar 

  23. Strike, P. C., & Steptoe, A. (2004). Psycholosocial factors in the development of coronary artery disease. Progress in Cardiovascular Diseases, 46, 337–347.

    Article  PubMed  Google Scholar 

  24. Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2008). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 98(1), S29–S37.

    Article  PubMed  Google Scholar 

  25. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.

    Article  PubMed  Google Scholar 

  26. Katz-Wise, S. B., & Hyde, J. S. (2012). Victimization experiences of lesbian, gay, and biseuxal individuals: A Meta-Analysis. Journal of Sex Research, 49(2–3), 142–167.

    Article  PubMed  Google Scholar 

  27. Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: Implications for Young Adult Health and Health Adjustment. Journal of School Health, 81(5), 223–230.

    Article  PubMed  Google Scholar 

  28. Austin, S. B., Ziyadeh, N. J., Corliss, H. L., et al. (2009). Sexual orientation disparities in weight status in adolescence: Findings from a prospective study. Obesity, 17, 1776–1782.

    Article  PubMed  Google Scholar 

  29. Boehmer, U., Bowen, D. J., & Bauer, G. R. (2007). Overweight and obesity in sexual-minority females: Evidence from population-based data. American Journal of Public Health, 97, 1134–1140.

    Article  PubMed  Google Scholar 

  30. Case, P., Austin, S. B., Hunter, D. J., et al. (2004). Sexual orientation, health risk factors, and physical functioning in the Nurses’ Health Study II. J Women’s Health, 13, 1033–1047.

    Article  Google Scholar 

  31. Roberts, S. A., Dibble, S. L., Nussey, B., & Casey, K. (2003). Cardiovascular disease risk in lesbian females. Women’s Health Issues, 13, 167–174.

    Article  PubMed  Google Scholar 

  32. Cochran, S. D., & Mays, V. M. (2007). Physical health complaints among lesbians, gay males, and bisexual and homosexually experienced heterosexual individuals: Results from the California Quality of Life Survey. American Journal of Public Health, 97, 2048.

    Article  PubMed  Google Scholar 

  33. Dean, L., Meyer, I. H., Robinson, K., et al. (2000). Lesbian, gay, bisexual, and transgender health: Findings and concerns. Journal of the Gay and Lesbian Medical Association, 4, 102–151.

    Article  Google Scholar 

  34. Heck, J. E., & Jacobson, J. S. (2006). Asthma diagnosis among individuals in same-sex relationships. Journal of Asthma, 43, 579–584.

    Article  PubMed  Google Scholar 

  35. Sandfort, T. G., Bakker, F., Schellevis, F. G., & Vanwesenbeeck, I. (2006). Sexual orientation and mental and physical health status: Findings from a Dutch population survey. American Journal of Public Health, 96, 1119–1125.

    Article  PubMed  Google Scholar 

  36. Ambrose, J. A., & Barua, R. S. (2004). The pathology of cigarette smoking and cardiovascular disease: An update. Journal of the American College of Cardiology, 43, 1731–1737.

    Article  PubMed  CAS  Google Scholar 

  37. Haapanen-Niemi, N., Miilunpalo, S., Pasanen, M., et al. (2000). Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality—16 y follow-up of middle-aged and elderly males and females. International Journal of Obesity and Related Metabolic Disorders, 24, 1465–1474.

    Article  PubMed  CAS  Google Scholar 

  38. Kraus, W. E., Houmard, J. A., Duscha, B. D., et al. (2002). Effects of the amount and intensity of exercise on plasma lipoproteins. The New England Journal of Medicine, 347, 1483–1492.

    Article  PubMed  CAS  Google Scholar 

  39. Bearman, P. S., Jones, J., & Udry, J. R. (1997). The National Longitudinal Study of Adolescent Health: Research design. Available at: http://www.cpc.unc.edu/projects/addhealth/design.html.

  40. U.S. Department of Health and Human Services [US DHHS]. (2003). The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). NIH Publication No. 03-5233. Washington, DC: National Institute of Health.

  41. Tobin, M. D., Sheehan, N. A., Scurrah, K. J., & Burton, P. R. (2005). Adjusting for treatment effects in studies of quantitative traits: Antihypertensive therapy and systolic blood pressure. Statistics in Medicine, 24, 2911–2935.

    Article  PubMed  Google Scholar 

  42. World Health Organization (WHO). (2000). Obesity: Preventing and managing the global epidemic. WHO technical report series.

  43. Cutler, J. A., Sorlie, P. D., Wolz, M., et al. (2008). Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension, 52, 818–827.

    Article  PubMed  CAS  Google Scholar 

  44. D’augelli, A. R., Grossman, A. H., & Starks, M. T. (2006). Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth. Journal of Interpersonal Violence, 21(11), 1462–1482.

    Article  PubMed  Google Scholar 

  45. Roberts, A. L., Rosario, M., Corliss, H. L., Koenen, K. C., & Austin, S. B. (2012). Childhood gender nonconformity: A risk indicator for childhood abuse and posttraumatic stress in youth. Pediatrics, 129(3), 410–417.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the Eunice Shriver National Institute of Child Health and Human Development (NICHD) grant R03 HD062597, NICHD and Office of Research on Women’s health (ORWH) grant number K12HD055892, and by the University of Colorado Population Center (Grant R24 HD066613) through administrative and computing support. We also thank Dr. S. Bryn Austin for her insightful comments.

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Authors and Affiliations

  1. University of Illinois at Chicago, Chicago, IL, USA

    Bethany Everett

  2. University of Colorado at Boulder, Chicago, IL, USA

    Stefanie Mollborn

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Correspondence to Bethany Everett.

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Everett, B., Mollborn, S. Differences in Hypertension by Sexual Orientation Among U.S. Young Adults. J Community Health 38, 588–596 (2013). https://doi.org/10.1007/s10900-013-9655-3

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