Heart Disease in the LGBTQIA+ Community

Heart disease is the leading cause of death in the United States. According to the Centers for Disease Control and Prevention (CDC), one in every 4 U.S. deaths is due to heart disease, and someone dies from heart disease every 36 seconds in the U.S.

Moreover, studies suggest members of the LGBTQIA+ community have a greater risk of heart disease than other individuals.

Transgender women are almost twice as likely to have coronary artery disease than cisgender women. Trans women are also almost twice as likely to have strokes and 3 times as likely to have heart attacks than cis women.

Trans men have more than double the risk of a heart attack than cis men. Compared to cisgender women, transgender men are nearly 5 times more likely to have a heart attack.

What Is Heart Disease?

Heart disease refers to several different heart conditions. The most common type is coronary artery disease. This disease occurs when plaque builds up in the arteries, which carry blood throughout the body.

The plaque comes from cholesterol, a waxy substance the body uses to build cells and carry out other body processes. The liver makes cholesterol for the body’s needs, but people also get cholesterol from foods that come from animals. This includes red meat, poultry, fish, and dairy products.

Even though the body needs cholesterol, too much cholesterol leads to the plaque that collects in arteries. The build-up makes arteries narrower, which can partially or completely block blood flow in the body. This can eventually lead to a heart attack.

Although there are other types of heart disease, the same major factors contribute to all types.

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Risk Factors for Heart Disease

The biggest risk factors for heart disease are high blood pressure, high cholesterol, and smoking. Medical conditions and lifestyle behaviors that increase your risk of heart disease include:

  • Diabetes.
  • Excessive alcohol use.
  • Obesity.
  • Physical inactivity.
  • An unhealthy diet.
  • Stress.

Heart disease risk also varies by geography. Rates are highest in southern U.S. states, the lower Midwest, and Nevada. Some people also may have a higher or lower risk of heart disease due to family medical history.

Why LGBTQIA+ People Have Higher Heart Disease Risk

Studies suggest that LGBTQIA+ people are disproportionately affected by various health issues. For example, diabetes and obesity are more common in LGBTQIA+ adults than in other adults. LGBTQIA+ adults are also more likely to report tobacco use, as tobacco companies have historically targeted their products toward LGBTQ individuals.

Studies also suggest that LGBTQIA+ individuals are disproportionately exposed to psychological and social stressors throughout their lives, which increase their risk of cardiovascular disease. These stressors include:

  • Higher risk of medical conditions like HIV.
  • Financial stress.
  • Increased risk of relationship and hate crime violence.
  • Institutional, societal, and economic discrimination.
  • Rejection by family and friends.
  • Social stigma.

Increased stress from these and other factors is associated with unhealthy behaviors such increased use of tobacco, alcohol, or other drugs.

Stress can also negatively affect sleeping habits. Research has found that not getting enough sleep is more common in LGBTQIA+ adults than in others. Too little sleep, sleep disorders, and poor sleep can increase your risk of heart disease.

What You Can Do

You cannot change your genetics or family medical history to reduce your risk of heart disease. You also cannot change factors such as air pollution that can increase the risk of heart disease. But you can learn about the risk factors you can control and take steps to improve them.

Pay attention to your numbers

Keep track of your blood pressure and cholesterol with your doctor. If your blood pressure or cholesterol is high, talk to your doctor about medicines and lifestyle changes that can help lower it.

Eat a healthy diet

A healthy diet is one of the most important ways to decrease your risk of heart disease. The American Heart Association offers these tips for a healthy diet:

  • Limit the amount of red meat, sugars, sodium, sugary drinks, and food with trans fats you eat.
  • Eat a variety of fruits and vegetables.
  • Eat whole grains instead such as whole wheat bread and brown rice instead of refined grains such as white bread and white rice.
  • Eat lean proteins, such as fish, poultry, low-fat dairy, nuts, and legumes.
  • Use olive oil and corn oil instead of coconut oil or palm oil.

Get regular physical exercise

Regular exercise is important to improve your heart health. The CDC recommends 150 minutes of physical activity each week. That’s about 30 minutes of activity 5 days every week.

Manage your stress

High levels of stress or ongoing stress can increase blood pressure and your risk of heart disease. Unfortunately, members of the LBGTQIA+ community face widespread discrimination in the U.S., which greatly increases stress.

Meditation and mindfulness can help reduce stress. Exercise is also an excellent and effective way to relieve the effects of stress on your body. Other ways to reduce stress include talking with a therapist and spending time with supportive friends.

Cut out unhealthy habits

If you smoke, talk to your doctor about getting help to quit. If you drink alcohol, drink moderate amounts. The CDC recommends no more than one drink per day for women or two for men. Ask your doctor what limit makes the most sense for you.

Experts at the UPMC Heart and Vascular Institute recognize that structural inequities and social determinants of health have led to heart disease being more prevalent in the LGBTQIA+ community. Visit our website to learn more or schedule an appointment.

Billy A. Caceres, Carl G. Streed Jr, Heather L. Corliss, et al. Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association. Circulation. November 10, 2020. Link

Billy A Caceres, Kasey B Jackman, Donald Edmondson, Walter O Bockting. Assessing gender identity differences in cardiovascular disease in US adults: an analysis of data from the 2014-2017 BRFSS. Journal of Behavioral Medicine. September 26, 2019. Link

Carl Streed Jr, Billy Caceres, Monica Mukherjee. Preventing cardiovascular disease among sexual and gender minority persons. Heart. February 16, 2021. Link

Heart Disease Facts. Heart Disease. Centers for Disease Control and Prevention. Link

Hongying Dai, Jianqiang Hao. Sleep Deprivation and Chronic Health Conditions Among Sexual Minority Adults. Behavioral Sleep Medicine. May/June 2019. Link

How Does Sleep Affect Your Heart Health? High Blood Pressure. Centers for Disease Control and Prevention. Link

Linking Air Pollution and Heart Disease. U.S. Environmental Protection Agency. Link

Talal Alzahrani, Tran Nguyen, Angela Ryan, et al. Cardiovascular Disease Risk Factors and Myocardial Infarction in the Transgender Population. Circulation: Cardiovascular Quality and Outocomes. April 2019. Link

Ten Things Every LGBT Older Adult Should Know About Heart Disease. Sage Health Services: Take Charge of Your Health. National Resource Center on LGBT Aging. Link

The American Heart Association Diet and Lifestyle Recommendations. The American Heart Association. Link

What is Cholesterol? The American Heart Association. Link

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.