Written by: Alyssa Sevilla
Clinically reviewed by: Robert Philibert
Heart disease remains a leading cause of death worldwide, affecting millions of people each year. While heart disease impacts people from all backgrounds, the LGBTQ+ community faces unique challenges and risks when it comes to their heart health. This article aims to address these specific concerns and provide information on how to overcome the obstacles faced by gay, lesbian, transgender, queer, gender fluid, and non-binary individuals in managing and preventing heart disease.
Understanding the Unique Risk Factors
Several factors contribute to the increased vulnerability of the LGBTQ+ community to heart disease. These factors range from lifestyle choices to physiological differences and social stressors.
Chronic Stress and Allostatic Load
One of the significant factors contributing to the increased risk of heart disease among LGBTQ+ individuals is chronic stress. According to Dr. Erin Michos, associate director of preventive cardiology at Johns Hopkins University School of Medicine, stress can lead to chronic inflammation, which in turn raises blood pressure and heart rate. This increased stress comes from various sources, such as discrimination, harassment, and the process of coming out.
The concept of allostatic load helps explain the cumulative toll that chronic stress takes on the brain and body. Scott Bertani, the director of advocacy at HealthHIV, a nonprofit focused on advancing prevention and care for people at risk for H.I.V., states that it is only natural for the body to respond to complex and challenging life events and demands. As reports of discrimination follow LGBTQ+ adults into healthcare settings, understanding why and how this stress occurs is critical to truly understanding this community’s health profile.
Sleep Issues and Heart Health
Mounting evidence shows that LGBTQ+ adults experience more sleep issues and interruptions than the general population. Dr. Caceres, a researcher in the field, explains that there is a significant link between sleep and heart health. The sleep problems faced by LGBTQ+ individuals may be tied to chronic stress, further exacerbating the risks associated with heart disease. Prolonged sleep deprivation can negatively impact several cardiovascular risk factors, including blood pressure, cholesterol levels, and inflammation. Disruptions in these factors can contribute to the development of heart disease over time. Research suggests insufficient sleep may also be associated with an increased risk of heart attacks and strokes. According to a study published in the European Heart Journal, individuals who slept for six hours or less per night had a 48% higher risk of developing or dying from coronary heart disease compared to those who slept for seven to eight hours.
Overcoming Obstacles to Seeking Care
A 2017 survey of nearly 500 LGBTQ+ adults conducted by researchers at Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation found that more than one in six reported avoiding healthcare because they worried about discrimination. This hesitancy means that LGBTQ+ adults are less likely to access potentially lifesaving preventive healthcare, says Dr. Michos. All adults should be screened at least once a year for cardiovascular risk factors, which is typically part of an annual physical.
Finding Inclusive Medical Providers
In order to prevent heart disease, LGBTQ+ adults must find medical providers with whom they feel comfortable and safe. Dr. Streed recommends seeking out supportive medical practitioners who are knowledgeable about the unique challenges faced by LGBTQ+ individuals.
The Gay and Lesbian Medical Association offers a directory on its website that allows patients to find health professionals who are inclusive of LGBTQ patients. Additionally, The Human Rights Campaign creates an annual Healthcare Equality Index, a list of healthcare facilities committed to providing inclusive care for LGBTQ+ individuals.
Improving Heart Health for LGBTQ Adults
While addressing the unique risk factors and challenges faced by LGBTQ+ individuals is essential, it is also important to focus on general heart health strategies that can benefit everyone.
Gender-Affirming Hormones and Heart Health
Dr. Michos notes that while gender-affirming hormones have been shown to impact mental health positively, there is some evidence that high amounts of testosterone and estrogen can have cardiovascular risks. People taking these hormones should consult their doctors about maintaining their heart health while undergoing hormone therapy. Understanding that taking such medications is an elevated risk is essential for monitoring your heart health, just like any other prescription drug.
Lifestyle modifications are a crucial component of heart disease prevention and management. The following are some general recommendations for maintaining a healthy lifestyle:
- Regular physical activity: Engaging in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic activity per week can help reduce the risk of heart disease.
- Eating a healthy diet: Consuming a diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats can help lower cholesterol levels and maintain a healthy weight.
- Maintaining a healthy weight: Obesity is a significant risk factor for heart disease. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce this risk.
- Managing stress: Stress management techniques, such as mindfulness, meditation, yoga, or engaging in healthy hobbies, can help alleviate chronic stress and its effects on heart health.
- Avoiding tobacco and limiting alcohol consumption: Substance abuse is a significant risk factor for heart disease in the LGBTQ+ community. Quitting smoking and limiting alcohol intake can help reduce these risks.
Regular Checkups and Communication with Healthcare Providers
Regular checkups with healthcare providers can help identify and manage risk factors for heart disease. It is vital for LGBTQ+ individuals to find healthcare providers who are knowledgeable about their unique challenges and to communicate their concerns and needs openly.
Heart disease is a significant concern for the LGBTQ+ community, as they face unique risk factors and challenges in accessing care. By understanding these risks, finding inclusive healthcare providers, and taking proactive steps toward maintaining heart health, LGBTQ+ individuals can reduce their risk of developing heart disease and improve their overall well-being.