{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:50:28Z","timestamp":1789026628371,"version":"build-2803163510"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,11,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Seven million lesbian, gay, and bisexual (LGB) adults will be aged &gt;50\u2009years by 2030; assessing and addressing their risk for cardiovascular disease is critical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We analyzed a nationwide cohort using the Veterans Health Administration data. Sexual orientation (SO) was classified via a validated natural language processing algorithm. Prevalent atherosclerotic cardiovascular disease (ASCVD) (history of acute myocardial infarction, ischemic stroke, or revascularization) was identified via\n                      <jats:italic>International Classification of Diseases, Ninth and Tenth Revision<\/jats:italic>\n                      (\n                      <jats:italic>ICD\u20109<\/jats:italic>\n                      and\n                      <jats:italic>ICD\u201010<\/jats:italic>\n                      ) codes. The index date was the date of the first primary care appointment on or after October 1, 2009. We ascertained covariates and prevalent ASCVD in the year following the index date; the baseline date was 1 year after the index date. We calculated sample statistics by sex and SO and used logistic regression analyses to assess associations between SO and prevalent ASCVD. Of 1\u2009102\u2009193 veterans with natural language processing\u2010defined SO data, 170\u2009861 were classified as LGB. Prevalent ASCVD was present among 25\u2009031 (4105 LGB). Adjusting for age, sex, race, and Hispanic ethnicity, LGB veterans had 1.24 [1.19\u20131.28] greater odds of prevalent ASCVD versus non\u2010LGB identified veterans. This association remained significant upon additional adjustment for the ASCVD risk factors substance use, anxiety, and depression (odds ratio [OR],1.17 [95% CI, 1.13\u20131.21]). Among a subset with self\u2010reported SO, findings were consistent (OR, 1.53 [95% CI, 1.20\u20131.95]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is one of the first studies to examine cardiovascular risk factors and disease of the veteran population stratified by natural language processing\u2010defined SO. Future research must explore psychological, behavioral, and physiological mechanisms that result in poorer cardiovascular health among LGB veterans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036898","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T05:18:43Z","timestamp":1730956723000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalent Atherosclerotic Cardiovascular Disease Among Veterans by Sexual Orientation"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3075-253X","authenticated-orcid":false,"suffix":"Jr","given":"Carl G.","family":"Streed","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of General Internal Medicine Boston University Chobanian and Avedisian School of Medicine Boston MA USA"},{"name":"GenderCare Center Boston Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-8503","authenticated-orcid":false,"given":"Meredith S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Kentucky Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4174-9709","authenticated-orcid":false,"given":"Kory R.","family":"Heier","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Kentucky Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Elizabeth","family":"Workman","sequence":"additional","affiliation":[{"name":"Biomedical Informatics Center George Washington University Washington DC USA"},{"name":"Washington DC VA Medical Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3302-5047","authenticated-orcid":false,"given":"Lauren B.","family":"Beach","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences Feinberg School of Medicine, Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6865-5546","authenticated-orcid":false,"given":"Billy A.","family":"Caceres","sequence":"additional","affiliation":[{"name":"School of Nursing Columbia University Irving Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine New Haven CT USA"},{"name":"Veterans Affairs Connecticut Healthcare System West Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Skanderson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine New Haven CT USA"},{"name":"Veterans Affairs Connecticut Healthcare System West Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0842-804X","authenticated-orcid":false,"given":"Joseph L.","family":"Goulet","sequence":"additional","affiliation":[{"name":"Veterans Affairs Connecticut Healthcare System West Haven CT USA"},{"name":"Department of Emergency Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001052"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000914"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2017.0220"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303630"},{"key":"e_1_3_2_7_2","unstructured":"Jones JM. 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