Factors associated with cardiovascular health status among older men who have sex with men in China: a cross-sectional study

Objective: To examine cardiovascular health and associated factors among older men who have sex with men (MSM) in China. Methods: A cross-sectional study was conducted from May to October 2025 in Wuhan, China. Cardiovascular health was assessed using Life's Essential Eight. Internalized homophobia, attitudes toward medical help-seeking, social support, and health literacy were assessed. Associated factors were examined using bivariate and multiple linear regression. Results: Older MSM had moderate overall cardiovascular health (mean ± SD: 58.04 ± 19.24), which was lower than that of older men in the general Chinese population. Monthly income >USD 1389 was associated with higher cardiovascular health (unstandardized beta: 7.17, 95% CI: 2.69, 11.65), whereas nursing home residence was associated with lower cardiovascular health (unstandardized beta:-5.31, 95% CI: -9.42, -1.20). More positive attitudes toward medical help-seeking were associated with higher cardiovascular health (unstandardized beta: 0.15, 95% CI: 0.05, 0.25), whereas greater internalized homophobia was associated with lower cardiovascular health (unstandardized beta: -0.20, 95% CI: -0.39, -0.02). Conclusions: Cardiovascular health was suboptimal among older MSM. Greater attention to cardiovascular health promotion is warranted, particularly among those with socioeconomic and psychosocia vulnerablilities. Early detection, timely intervention, and culturally competent healthcare may help improve cardiovascular health in this population.