Psychological Distress Is Differentially Associated with Resting Cardiovascular Indices in Cisgender LGBQ and Heterosexual Young Adults

Sexual minority populations experience disproportionate psychosocial stress and cardiovascular disease risk, yet the relationship between psychological distress and cardiovascular regulation early in adulthood remains incompletely understood. We examined associations between depression, anxiety, and stress and resting cardiovascular indices in 96 cisgender young adults (39 queer, 57 heterosexual; age 18–35 yr). Participants completed the Depression Anxiety Stress Scales-21 (DASS-21), and resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed. Queer participants reported greater depression (12.5 ± 9.2 vs. 7.5 ± 5.7), anxiety (13.0 ± 7.1 vs. 7.4 ± 6.4), and stress (18.7 ± 8.7 vs. 12.3 ± 7.7; all P ≤ 0.004) than heterosexual participants, whereas resting SBP, DBP, and HR did not differ between groups. In multivariable regression analyses stratified by sexual orientation, anxiety was positively associated with DBP in queer participants (β = 0.43, P = 0.0495), whereas stress was inversely associated with HR (β = −0.58, P = 0.044). Neither association was observed in heterosexual participants or the overall aggregated sample. Exploratory item-level analyses further identified distinct associations between individual DASS-21 symptoms and HR across sexual orientation groups. These findings demonstrate that psychological distress is differentially associated with resting cardiovascular regulation in queer and heterosexual young adults despite similar resting hemodynamic profiles. Distinct relationships between psychosocial factors and cardiovascular indices may precede overt cardiovascular differences and provide insight into early pathways contributing to cardiovascular health inequities in sexual minority populations.