Over the past few decades, we have become increasingly aware that cardiovascular disease disproportionately affects minority groups such as black and Hispanic Americans. It is perhaps no surprise, then, that one of these affected groups is the LGBTQ+ community. A 2021 study highlighted by the National Institutes of Health sampled nearly 700,000 adults and found that gay, lesbian, and bisexual individuals are at higher odds of having heart-related chronic diseases than heterosexuals. Another study by BMC Public Health found that lesbians have a higher prevalence of obesity and stroke while gay men were more likely to suffer from hypertension and heart disease.

Like many other underserved minority groups, LGBTQ+ people may face a higher risk of heart disease due to a mix of social and physiologic factors that we are still learning about. One of the major factors that is thought to affect the heart and vascular health of LGBTQ+ people is “minority stress,” where prejudice and stigma against a minority group can lead to chronic stress which in turn results in adverse social, physical, and mental health outcomes.

Across the country, LGBTQ+ people continue to face unique social, structural, and interpersonal stressors such as family rejection, bias-motivated violence, and discrimination. Psychosocial stress has long-term effects on inflammation, blood pressure and heart rate that can increase the risk of heart attacks, stroke, and heart failure. Minority stress has also been associated with increased risky behaviors like smoking and excessive drinking, which can seriously impact the heart.

Gender-affirming hormone therapy is often integral to the well-being of people who are transgender or gender nonbinary. While we are still learning about the full effects of gender-affirming therapy on cardiac health, studies have found that gender-affirming hormones can influence a person’s blood pressure and cholesterol levels. In some instances, feminizing hormones may make one more susceptible to blood clots. As such, some people may require additional monitoring and treatment to protect their cardiovascular health as they go through their gender transition.

Greenwich Village has long been the historic center and home to many LGBTQ+ people. That the LGBTQ+ community continues to face disparities in their heart health and challenges in attaining appropriate health care is troubling. This has led me to build a program to address the unique cardiovascular needs of the LGBTQ+ community in the heart of Greenwich Village at Lenox Health Greenwich Village. We are focused on providing evidence-based compassionate care and are working hard to learn more about the specific needs of LGBTQ+ patients. We share that information and best practices with other cardiologists and primary care physicians in New York and around the country.

Greenwich Village thrives when lesbian, gay, bisexual, trans and queer folk can live and work healthily within it and beyond. My hope is that through our work, the heart of the LGBTQ+ community will continue to beat strongly for many years to come.