Statin Use for Atherosclerotic Cardiovascular Disease Prevention Among Sexual Minority Adults

Abstract

Background Sexual minority, or lesbian, gay, and bisexual (LGB), individuals are at increased risk for cardiovascular disease attributable to elevated rates of health risk factors. However, although there is clear evidence that statin use can prevent cardiovscular disease in certain adult populations, no studies have examined how statins are being used among the LGB population. This study aimed to examine the prevalence and predictors of statin use among LGB and non‐LGB individuals using Facebook‐delivered online surveys. Methods and Results We conducted a cross‐sectional online survey about statin use in adults ≥40 years of age between September and December 2019 using Facebook advertising (n=1531). We calculated the prevalence of statin use by age, sexual orientation, and statin benefit populations. We used multivariable logistic regression to examine whether statin use differed by sexual orientation, adjusting for covariates. We observed a significantly lower rate of statin use in the LGB versus non‐LGB respondents (20.8% versus 43.8%; P <0.001) in the primary prevention population. However, the prevalence of statin use was not statistically different in the LGB versus non‐LGB respondents in the secondary prevention population. Adjusting for the covariates, the LGB participants were less likely to use statins than the non‐LGB respondents in the primary prevention population (odds ratio, 0.37; 95% CI, 0.19–0.70). Conclusions Our results are the first to emphasize the urgent need for tailored, evidence‐based cardiovascular disease prevention programs that aim to promote statin use, and thus healthy aging, in the LGB population.

Leveraging Implementation Science for Cardiovascular Health Equity: A Scientific Statement From the American Heart Association

“…Future studies should examine groups with disparately high CVD burden or suboptimal adoption of CVD EBPs, such as American Indian‚ Alaska Native‚ Asian‚ or Pacific Islander communities, both urban and rural settings, 2 and sexual and gender minority populations, as well. 73…”

“…Future studies should examine groups with disparately high CVD burden or suboptimal adoption of CVD EBPs, such as American Indian‚ Alaska Native‚ Asian‚ or Pacific Islander communities, both urban and rural settings, 2 and sexual and gender minority populations, as well. 73 For step 1, we demonstrate the equity-informed criteria for selecting EBPs that are suboptimally implemented yet effective in historically marginalized populations. Our findings highlight the need for better specification of EBP quality, generalizability, and implementation readiness in clinical trials and systematic reviews.…”