Abstract 9591: Minority Stress and Incident Hypertension in Sexual Minority Women

Abstract

Introduction: Sexual minority women (SMW; e.g., lesbian, bisexual) are at higher risk of hypertension than heterosexual women. Minority stressors (defined as unique psychosocial stressors attributed to sexual minority identity) are hypothesized to contribute to hypertension risk in SMW. However, research has yet to formally test the association of minority stressors with hypertension. We sought to examine the association between several key minority stressors and self-reported incident hypertension among SMW. Hypothesis: Minority stressors will be positively associated with incident hypertension in SMW. Methods: We conducted a secondary analysis of data from Chicago Health and Life Experiences of Women study, a 21-year longitudinal study of SMW’s health. Using two waves of data we examined the associations of minority stressors (i.e., experiences of discrimination, stigma consciousness, and internalized homophobia) with incident hypertension. We ran mutually adjusted logistic regression models to estimate the odds ratios of the associations between minority stressors and incident hypertension, after adjusting for demographics, insurance status, body mass index, and smoking status. Results: The analytic sample included 348 SMW; mean age 38.4 (±12.8) years. More than half were women of color (56.6%). Approximately 60% had completed a bachelor’s degree and most had healthcare insurance (73.6%). Mean follow-up was 7.0 (±0.6) years; during which 12.6% were diagnosed with hypertension. After covariate adjustment, we found that a 1-standard deviation increase in internalized homophobia scores was associated with higher odds of incident hypertension (AOR 1.50, 95% Cl = 1.05-2.10). Stigma consciousness (AOR 0.80, 95% CI = 0.52-1.23) and experiences of discrimination (AOR 1.13, 95% CI = 0.76-1.61) were not associated with incident hypertension. Conclusions: This is the first study to document that internalized homophobia is associated with incident hypertension in SMW. Future research is needed that examines the associations of minority stressors with objective measures of hypertension. Findings highlight there is a need for psychosocial interventions to reduce internalized homophobia and hypertension risk in SMW across the lifespan.