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Prevalent Atherosclerotic Cardiovascular Disease Among Veterans by Sexual Orientation

Authors :
Carl G. Streed
Meredith S. Duncan
Kory R. Heier
T. Elizabeth Workman
Lauren B. Beach
Billy A. Caceres
John R. O'Leary
Melissa Skanderson
Joseph L. Goulet
Source :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 22 (2024)
Publication Year :
2024
Publisher :
Wiley, 2024.

Abstract

Background Seven million lesbian, gay, and bisexual (LGB) adults will be aged >50 years by 2030; assessing and addressing their risk for cardiovascular disease is critical. Methods and Results We analyzed a nationwide cohort using the Veterans Health Administration data. Sexual orientation (SO) was classified via a validated natural language processing algorithm. Prevalent atherosclerotic cardiovascular disease (ASCVD) (history of acute myocardial infarction, ischemic stroke, or revascularization) was identified via International Classification of Diseases, Ninth and Tenth Revision (ICD‐9 and ICD‐10) codes. The index date was the date of the first primary care appointment on or after October 1, 2009. We ascertained covariates and prevalent ASCVD in the year following the index date; the baseline date was 1 year after the index date. We calculated sample statistics by sex and SO and used logistic regression analyses to assess associations between SO and prevalent ASCVD. Of 1 102 193 veterans with natural language processing‐defined SO data, 170 861 were classified as LGB. Prevalent ASCVD was present among 25 031 (4105 LGB). Adjusting for age, sex, race, and Hispanic ethnicity, LGB veterans had 1.24 [1.19–1.28] greater odds of prevalent ASCVD versus non‐LGB identified veterans. This association remained significant upon additional adjustment for the ASCVD risk factors substance use, anxiety, and depression (odds ratio [OR],1.17 [95% CI, 1.13–1.21]). Among a subset with self‐reported SO, findings were consistent (OR, 1.53 [95% CI, 1.20–1.95]). Conclusions This is one of the first studies to examine cardiovascular risk factors and disease of the veteran population stratified by natural language processing‐defined SO. Future research must explore psychological, behavioral, and physiological mechanisms that result in poorer cardiovascular health among LGB veterans.

Details

Language :
English
ISSN :
20479980
Volume :
13
Issue :
22
Database :
Directory of Open Access Journals
Journal :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Publication Type :
Academic Journal
Accession number :
edsdoj.05ba33faa98b48dbb97d2c3a5f268d49
Document Type :
article
Full Text :
https://doi.org/10.1161/JAHA.124.036898