Abstract 004: Longitudinal Change in Cardiovascular Health by Repeated Measures of Self-Reported Sexual Orientation Discrimination in the CARDIA Study Cohort

Abstract

Introduction: Few studies have investigated the association of self-reported discrimination based on sexual orientation with cardiovascular health. Objective: We assessed if repeated self-reported sexual orientation discrimination was associated with longitudinal cardiovascular health among males and females in the CARDIA study. Methods: CARDIA participants completed cardiovascular health assessments and sexual orientation discrimination measures in 1992-1993 (Year 7 Exam), 2015-2016 (Year 30 Exam), and 2020-2022 (Year 35 Exam). For each exam, participants reported if they experienced discrimination attributable to sexual orientation in 6 different contexts (at school, getting a job, at work, at home, getting medical care, and in public settings). The number of reported discrimination contexts was summed at each time point and assigned to one of four levels (0, 1, 2, or 3 or more experiences). Multiple imputation by chained equations was used to estimate missing exposure and outcome variables. Linear mixed models stratified by sex were used to estimate the associations between age, sexual orientation discrimination, and Life’s Simple 7 (LS7). The interaction of age and discrimination was used to estimate differences in change in LS7 over time (i.e., age) by levels of discrimination. Results: Median participant age was 54 years (SD 12.7 years), 55.3% of participants were female, and 49.7% were Black. Combining participant reports of females across all 3 exams, 83.5% reported 0, 4.8% reported 1, 2.6% reported 2, and 4.2% reported 3 or more contexts of sexual orientation discrimination. Among males, these percentages were 84.7%, 4.6%, 2.4%, 4.2%, respectively. The mean LS7 score across all visits for all participants was 7.68 (SD 1.78). Females who reported 3 or more sexual orientation discrimination contexts had significantly lower cardiovascular health than those who reported no sexual orientation discrimination (b = -0.60, p=0.008), but no significant difference in their rate of LS7 change from Year 7 to Year 35 Exam (b=0.02, p=0.15). There was no significant association between sexual orientation discrimination and cardiovascular health in males. Conclusions: Among females, sexual orientation discrimination was inversely associated with cardiovascular health. No significant differences were detected in males. Future studies will investigate if these findings vary by sexual identity and race.