Cardiovascular diseases—heart disease, stroke, and atherosclerosis—represent the leading cause of death for women in general. Risk factors for heart disease include cigarette smoking, high blood pressure (hypertension), high blood cholesterol, excessive weight, use of oral contraceptives, and physical inactivity (NHLBI, 1997). Although stress has been shown to be a possible risk factor for cardiovascular disease in men, this connection has not yet been demonstrated in women. Moderate consumption of alcohol (one or two drinks per day) may have some protective effects against cardiovascular disease as does the use of hormone replacement therapy for menopausal women.
There are no population-based data on cardiovascular disease among lesbians or on the factors that increase their risk for cardiovascular disease. There is some evidence that lesbians may have higher rates of smoking and higher BMI, two risk factors for cardiovascular disease. On the other hand, lesbians are less likely to use oral contraceptives, which may lower their risk for cardiovascular disease. Based on currently available data, the committee concludes that it is not possible to determine whether lesbians are indeed at higher risk for cardiovascular disease than women in general.
The most common mental disorders experienced by women in general are anxiety disorders. Data from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a probability sample in the United States, indicate that 30.5% of the women surveyed reported experiencing an anxiety disorder at some time in their lives (usually social phobia or simple phobia); 22.6% reported such a disorder during the past year (Kessler et al., 1994). The next most common category of mental disorders experienced by women in general is affective disorders, with depression being most commonly reported. In the National Comorbidity Survey, 23.9% of the women surveyed reported expe