Research on cardiovascular functioning in minority groups: From biological explanations to social and discrimination-related determinants

Objectives: Minority groups consistently exhibit poorer health outcomes than majority populations, a pattern often attributed to chronic exposure to distal and proximal stigma-related stressors. Such sustained stress is thought to disrupt autonomic regulation, and reduced heart rate variability is frequently cited as an indicator of physiological dysregulation associated with heightened vulnerability to adverse health outcomes. Study design: The present work implemented a scientometric approach to review the scientific literature on the physiological functioning of minority groups (e.g., racial, ethnic, gender, sexual, and neurological minorities). Methods: A total of 1945 papers published between 1953 and 2024 were retrieved from Scopus. Using CiteSpace, we analysed co-citation patterns and identified nine main research themes, along with the ten most impactful publications in the field. Results: The bibliometric results revealed a predominant contribution from authors based in the United States, whose work has largely focused on cardiometabolic disparities among ethnic minority populations. Additionally, we observed a clear shift in the research trajectory: from early efforts attributing ethnic health disparities to genetic and dietary differences, towards more recent investigations emphasising the deleterious effects of discrimination on minority health. Conclusions: This evidence map highlights the need to include discrimination, stigma, and minority stress in cardiovascular and autonomic health research, while improving evidence on sexual, gender, and neurodivergent minorities to guide public health priorities and prevention strategies.