IInfluence of psychosocial factors, physical activity status and body composition on blood pressure in lesbian, gay, bisexual and heterosexual young adults
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Abstract
Hypertension (HTN) is a major risk factor for cardiovascular morbidity and mortality. While estimated to affect 1 in 2 adults in the general population, HTN has recently been found to be more prevalent in individuals who are lesbian, gay, bisexual, transgender, and queer (LGBTQ+). Sexual minority adults have also been found to take on greater levels of tobacco and alcohol use, achieve greater levels of physical inactivity, and may have higher body mass index (BMI) when compared to heterosexual counterparts. HTN in the LGBTQ+ community is additionally thought to be mediated by excessive levels of identity-dependent psychosocial stress, as posited in the Minority Stress Theory. Previous studies examining the relation of stress and blood pressure in LGBTQ+ populations have largely been retrospective or used self-report data. We sought to pilot a study directly measuring stress, anxiety, and depression levels, cuff-based blood pressure and heart rate, self-reported physical activity levels and alcohol and tobacco use, as well as waist to hip ratios in healthy cisgender lesbian, gay, bisexual, and queer (LGBQ) and heterosexual emerging adults. Participants had a mean age of 21.9 years, representing early emerging adults. We identified that both stress and anxiety levels were significantly higher in grouped LGBQ individuals than heterosexual participants. However, we did not identify any significant differences in mean systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, physical activity status, waist to hip ratio, or alcohol and tobacco use. However, weekly minutes of moderate to strenuous cardiovascular physical activity had a significant inverse relationship with anxiety levels among LGB participants. This association was not significant among heterosexual participants. We conclude from these data that emerging adult LGBQ individuals may be at an elevated risk for HTN based on the excess stress and anxiety identified. Additionally, we conclude that physical activity is particularly effective at modulating anxiety levels among LGB emerging adults. The early twenties may represent a critical time point at which a risk factor for HTN (stress and anxiety) is present without the development of a hypertensive phenotype.
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2025