Depression, anxiety, stress, and resting blood pressure between cisgender queer and heterosexual emerging adults

Hypertension (HTN) is a major risk factor for cardiovascular morbidity and mortality. Affecting ∼ 50% of 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+). HTN in the LGBTQ+ community is hypothesized 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 implemented a small pilot study to directly measure stress, anxiety, and depression levels and cuff-based blood pressure and heart rate in healthy cisgender lesbian, gay, bisexual, and queer (LGBQ) emerging adults, who may be at risk for HTN, and heterosexual emerging adults, as low-risk referents. Individuals had a mean age of 22 ± 2 yr. We found that both stress and anxiety levels, as assessed by the DASS-21 survey tool, were higher in grouped queer individuals than in heterosexual individuals. However, we did not identify any differences in mean systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate between queer and heterosexual individuals. We conclude from these data that emerging adult queer individuals may be at an elevated risk for developing HTN compared with heterosexual individuals based on the excess stress and anxiety identified. The early twenties may represent a critical time point for mental health interventions to prevent the stress and anxiety from driving up blood pressure and causing HTN.NEW & NOTEWORTHY Our study extends the literature on cardiovascular risk factors in queer populations by identifying a critical time point when queer emerging adults have higher levels of stress and anxiety than their heterosexual peers, but no differences in brachial blood pressure. This points to a window of time for primary preventive interventions that may reduce the likelihood of stress and anxiety driving up blood pressure in these individuals.