Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association.
Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association.
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DOI：
10.1161/cir.0000000000000914
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发表时间：
2020-11-10
期刊：
影响因子：
37.8
通讯作者：
American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Hypertension; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council
中科院分区：
文献类型：
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作者：
Caceres BA;Streed CG Jr;Corliss HL;Lloyd-Jones DM;Matthews PA;Mukherjee M;Poteat T;Rosendale N;Ross LM;American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Hypertension; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council
越来越多的证据表明，女同性恋，男同性恋，双性恋，变性人和酷儿或质疑（LGBTQ）成年人与异性恋和/或顺性别同龄人相比，在几个心血管风险因素方面存在差异。这些差异被认为主要是由于在整个生命周期中暴露于心理社会压力因素。这份美国心脏协会的科学声明回顾了关于LGBTQ成年人心血管健康的现有文献。根据少数民族压力和社会生态模型，本声明的目标是：1）提出一个概念模型，以阐明LGBTQ成年人心血管健康差异的潜在机制，2）确定研究差距，3）为改善LGBTQ人群的心血管研究和护理提供建议。尽管存在方法上的局限性，但有证据表明LGBTQ成年人（特别是女同性恋、双性恋和变性女性）在几个心血管健康指标上存在差异。这些差异因种族、性别、性取向和性别认同而异。这一领域的未来研究应纳入纵向设计，阐明生理机制，评估心血管健康的社会和临床决定因素，并确定行为干预的潜在目标。有必要制定和测试干预措施，以解决影响LGBTQ成年人心血管健康的多层次压力源。关于LGBTQ健康的内容应纳入卫生专业课程和执业临床医生的继续教育。促进LGBTQ成年人的心血管健康需要一个多方面的方法，包括来自多个部门的利益相关者，将最佳实践纳入该人群的健康促进和心血管护理。
There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared to their heterosexual and/or cisgender peers. These disparities are posited to be driven primarily by exposure to psychosocial stressors across the lifespan. This American Heart Association scientific statement reviews the extant literature on the cardiovascular health of LGBTQ adults. Informed by the minority stress and social ecological models, the objectives of this statement were to: 1) present a conceptual model to elucidate potential mechanisms underlying cardiovascular health disparities in LGBTQ adults, 2) identify research gaps, and 3) provide suggestions for improving cardiovascular research and care of LGBTQ people. Despite the identified methodological limitations, there is evidence that LGBTQ adults (particularly lesbian, bisexual, and transgender women) experience disparities across several cardiovascular health metrics. These disparities vary by race, sex, sexual orientation, and gender identity. Future research in this area should incorporate longitudinal designs, elucidate physiological mechanisms, assess social and clinical determinants of cardiovascular health, and identify potential targets for behavioral interventions. There is a need to develop and test interventions that address multi-level stressors that impact the cardiovascular health of LGBTQ adults. Content on LGBTQ health should be integrated in health professions curricula and continuing education for practicing clinicians. Advancing the cardiovascular health of LGBTQ adults requires a multi-faceted approach that includes stakeholders from multiple sectors to integrate best practices into health promotion and cardiovascular care of this population.