title: CVD risk among men participating in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2010: differences by sexual minority status.
abstract: BACKGROUND
  Recent research indicates that sexual minority women are at increased risk for cardiovascular disease (CVD) compared with heterosexual women; however, few studies of CVD risk exist for sexual minority men (SMM). This study aimed to determine whether disparities in CVD risk exist for SMM and if CVD risk is consistent across subgroups of SMM.
  
  
  METHODS
  This study utilised publicly available data from the National Health and Nutrition Examination Survey (NHANES), pooled from 2001 to 2010. CVD risk was calculated using the Framingham General CVD Risk Score and operationalised as the ratio of a participant's vascular and chronological age. Differences in this ratio were examined between heterosexual and SMM as a whole, and within subgroups of SMM.
  
  
  RESULTS
  SMM had vascular systems that were, on average, 4% (95% CI -7.5% to -0.4%) younger than their heterosexual counterparts; however, adjustment for education and history of hard drug use rendered this difference statistically insignificant. Analysis of SMM subgroups revealed increased CVD risk for bisexual men and decreased CVD risk for both gay and homosexually experienced heterosexual men when compared with heterosexual men. Differences in CVD risk persisted for only bisexual and homosexually experienced heterosexual men after adjustment for education and history of hard drug use.
  
  
  CONCLUSIONS
  Subgroups of SMM are at increased risk for CVD compared with heterosexual men, and this increased risk cannot be completely attributed to differences in demographic characteristics or negative health behaviours.
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health & Social Justice, St Louis, Missouri 63104, USA. gwfm1978@gmail.com
authors.forename: Grant W
authors.initials: GW
authors.lastname: Farmer
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Bucholz
authors.forename: Louise H
authors.initials: LH
authors.lastname: Flick
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Burroughs
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
mesh_terms: D000328:Adult; D000368:Aged; D001727:Bisexuality / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D020010:Heterosexuality / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D011159:Population Surveillance; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Cardiovascular disease; GENDER; Health inequalities; SOCIAL INEQUALITIES