Bisexual men may have a particularly high risk of heart disease, according to a new study examining national health survey data on Americans. But how exactly does sexual orientation become an influence on heart health?

The study titled "Sexual Orientation Differences in Modifiable Risk Factors for Cardiovascular Disease and Cardiovascular Disease Diagnoses in Men" was published in the journal LGBT Health on June 11.

The research team analyzed data on 7,731 male participants between the ages of 20 to 59. They were divided into four groups based on their sexual identities: gay men, heterosexual men, bisexual men, and heterosexual men who have sex with men.

The two objectives of the study were to examine heart disease diagnoses among men of different sexual orientations and also measure their modifiable risk factors for heart disease.

While no correlation was found between sexual identities and heart disease diagnoses, bisexual men were found to have higher rates of several risk factors for heart disease compared to heterosexual men. These included mental distress, obesity, elevated blood pressure, etc.

The other three groups were found to have similar heart disease risk. The only difference observed in health behavior was that gay men reported lower binge drinking than straight men.

"Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men," said lead author Billy Caceres, an adjunct faculty member at Rory Meyers College of Nursing, New York University.

Minority stress is one of the major reasons behind the influence of sexual orientation on health, contributing toward chronic stress, risk behavior, poor mental health, and higher rates of drinking, smoking, and drug use.

Experts believe that substance use among minorities can be a reaction to homophobia, discrimination, or violence faced as a result of their orientation. The American Cancer Society also noted how the tobacco industry has targeted the LGBT community with aggressive marketing.

Strained relationships (such as a disapproving family) and the lack of a support system can go on to affect one's stability and mental health. "Poor mental health is a recognized risk factor for the development of heart disease," added Caceres, who is also a postdoctoral research fellow at Columbia University School of Nursing.

The Pew Research Center found that fewer bisexual individuals reported experiencing discrimination compared to gay men and lesbians. But when examining gender differences, bisexual women were thought to have higher levels of acceptance than bisexual men at 33 percent and 8 percent respectively.

The new study also demonstrated the importance of breaking down data regarding sexual minorities instead of lumping gay and bisexual participants together. The research team stated that this could help in identifying differences in health outcomes between the subgroups.

"Clinicians should be educated about sexual minority health and should routinely screen bisexual men for mental distress as a risk factor for heart disease," Caceres said, encouraging the inclusion of sexual orientation in demographic questionnaires for health records.