Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study

Background A higher burden of cardiovascular disease risk factors has been reported in sexual minority populations. Primordial prevention may therefore be a relevant preventative strategy. The study's objectives are to estimate the associations of Life's Essential 8 (LE8) and Life's S...

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Main Authors: Omar Deraz, Billy Caceres, Carl G. Streed, Lauren B. Beach, Xavier Jouven, Mathilde Touvier, Marcel Goldberg, Marie Zins, Jean‐Philippe Empana
Format: Article
Language:English
Published: Wiley 2023-06-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.122.028429
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author Omar Deraz
Billy Caceres
Carl G. Streed
Lauren B. Beach
Xavier Jouven
Mathilde Touvier
Marcel Goldberg
Marie Zins
Jean‐Philippe Empana
author_facet Omar Deraz
Billy Caceres
Carl G. Streed
Lauren B. Beach
Xavier Jouven
Mathilde Touvier
Marcel Goldberg
Marie Zins
Jean‐Philippe Empana
author_sort Omar Deraz
collection DOAJ
description Background A higher burden of cardiovascular disease risk factors has been reported in sexual minority populations. Primordial prevention may therefore be a relevant preventative strategy. The study's objectives are to estimate the associations of Life's Essential 8 (LE8) and Life's Simple 7 (LS7) cardiovascular health scores with sexual minority status. Methods and Results The CONSTANCES is a nationwide French epidemiological cohort study that recruited randomly selected participants older than 18 years in 21 cities. Sexual minority status was based on self‐reported lifetime sexual behavior and categorized as lesbian, gay, bisexual, or heterosexual. The LE8 score includes nicotine exposure, diet, physical activity, body mass index, sleep health, blood glucose, blood pressure, and blood lipids. The previous LS7 score included 7 metrics without sleep health. The study included 169 434 cardiovascular disease–free adults (53.64% women; mean age, 45.99 years). Among 90 879 women, 555 were lesbian, 3149 were bisexual, and 84 363 were heterosexual. Among 78 555 men, 2421 were gay, 2748 were bisexual, and 70 994 were heterosexual. Overall, 2812 women and 2392 men declined to answer. In multivariable mixed effects linear regression models, lesbian (β=−0.95 [95% CI, −1.89 to −0.02]) and bisexual (β=−0.78 [95% CI, −1.18 to −0.38]) women had a lower LE8 cardiovascular health score compared with heterosexual women. Conversely, gay (β=2.72 [95% CI, 2.25–3.19]) and bisexual (β=0.83 [95% CI, 0.39–1.27]) men had a higher LE8 cardiovascular health score compared with heterosexual men. The findings were consistent, although of smaller magnitudes for the LS7 score. Conclusions Cardiovascular health disparities exist in sexual minority adults, particularly lesbian and bisexual women, who may represent a priority population for primordial cardiovascular disease prevention.
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spelling doaj-art-d66404def6b34c24a76496c42e1cf2802025-08-20T03:49:21ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-06-01121110.1161/JAHA.122.028429Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based StudyOmar Deraz0Billy Caceres1Carl G. Streed2Lauren B. Beach3Xavier Jouven4Mathilde Touvier5Marcel Goldberg6Marie Zins7Jean‐Philippe Empana8Université Paris Cité, INSERM, UMR‐S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris FranceColumbia University School of Nursing New York NY USASection of General Internal Medicine Boston University School of Medicine Boston MA USADepartment of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL USAUniversité Paris Cité, INSERM, UMR‐S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris FranceSorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS) Bobigny FranceUniversité Paris Cité, "Population‐based Cohorts Unit," INSERM, Paris Saclay University Villejuif FranceUniversité Paris Cité, "Population‐based Cohorts Unit," INSERM, Paris Saclay University Villejuif FranceUniversité Paris Cité, INSERM, UMR‐S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris FranceBackground A higher burden of cardiovascular disease risk factors has been reported in sexual minority populations. Primordial prevention may therefore be a relevant preventative strategy. The study's objectives are to estimate the associations of Life's Essential 8 (LE8) and Life's Simple 7 (LS7) cardiovascular health scores with sexual minority status. Methods and Results The CONSTANCES is a nationwide French epidemiological cohort study that recruited randomly selected participants older than 18 years in 21 cities. Sexual minority status was based on self‐reported lifetime sexual behavior and categorized as lesbian, gay, bisexual, or heterosexual. The LE8 score includes nicotine exposure, diet, physical activity, body mass index, sleep health, blood glucose, blood pressure, and blood lipids. The previous LS7 score included 7 metrics without sleep health. The study included 169 434 cardiovascular disease–free adults (53.64% women; mean age, 45.99 years). Among 90 879 women, 555 were lesbian, 3149 were bisexual, and 84 363 were heterosexual. Among 78 555 men, 2421 were gay, 2748 were bisexual, and 70 994 were heterosexual. Overall, 2812 women and 2392 men declined to answer. In multivariable mixed effects linear regression models, lesbian (β=−0.95 [95% CI, −1.89 to −0.02]) and bisexual (β=−0.78 [95% CI, −1.18 to −0.38]) women had a lower LE8 cardiovascular health score compared with heterosexual women. Conversely, gay (β=2.72 [95% CI, 2.25–3.19]) and bisexual (β=0.83 [95% CI, 0.39–1.27]) men had a higher LE8 cardiovascular health score compared with heterosexual men. The findings were consistent, although of smaller magnitudes for the LS7 score. Conclusions Cardiovascular health disparities exist in sexual minority adults, particularly lesbian and bisexual women, who may represent a priority population for primordial cardiovascular disease prevention.https://www.ahajournals.org/doi/10.1161/JAHA.122.028429cardiovascular diseasespreventive medicinerural populationsexual and gender minoritieswomen's health
spellingShingle Omar Deraz
Billy Caceres
Carl G. Streed
Lauren B. Beach
Xavier Jouven
Mathilde Touvier
Marcel Goldberg
Marie Zins
Jean‐Philippe Empana
Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular diseases
preventive medicine
rural population
sexual and gender minorities
women's health
title Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
title_full Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
title_fullStr Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
title_full_unstemmed Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
title_short Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population‐Based Study
title_sort sexual minority status disparities in life s essential 8 and life s simple 7 cardiovascular health scores a french nationwide population based study
topic cardiovascular diseases
preventive medicine
rural population
sexual and gender minorities
women's health
url https://www.ahajournals.org/doi/10.1161/JAHA.122.028429
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