Determinants of Cardiovascular Disease Risk Among <scp>LGBTQ</scp> + Populations: A Systematic Review of Empirical Evidence

BACKGROUND: Understanding the multifactorial drivers of cardiovascular disease (CVD) risk in LGBTQ+ populations is critical to advancing equitable cardiovascular care. OBJECTIVE: To evaluate and synthesize empirical evidence on factors influencing CVD risk among sexual minority populations. METHODS: A systematic review was conducted following PRISMA guidelines. Five databases (PubMed, Scopus, MEDLINE, ScienceDirect and ProQuest) were searched for studies published between 2019 and 2024 that examined CVD risk factors among LGBTQ+ adults. Eligible studies were appraised using the Joanna Briggs Institute critical appraisal tool, and findings were synthesized using a convergent integrated approach. RESULTS: Twenty studies met the inclusion criteria, most of which were cross-sectional and conducted in high-income countries. Identified CVD risk factors were classified into six domains: behavioural (e.g., nicotine use, health behaviours, substance use), blood biomarker (e.g., lipid or total cholesterol, HbA1c, C-reactive protein), physical (e.g., BMI, blood pressure, age), comorbidities (e.g., metabolic syndrome, COPD, HIV), psychological (e.g., positive and negative factors) and social (e.g., discrimination, loneliness, marital status). Bisexual, lesbian and gay individuals were most frequently represented. Across studies, minority stress and adverse social determinants were consistently associated with elevated CVD risk. CONCLUSION: Sexual minority populations face disproportionate cardiovascular risk shaped by behavioural, biological and psychosocial stressors. These findings highlight the need for inclusive, culturally competent nursing practice and identity-informed screening strategies. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nurses should integrate sexual orientation and gender identity into cardiovascular risk assessments, adopt trauma-informed and resilience-promoting approaches, and advocate for policies that reduce structural barriers to equitable care. PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were directly involved in the design, conduct or reporting of this systematic review.