Abstract
Background
The transgender population is rapidly growing in the United States and abroad. Transgender
men and women are marginalized as a result of their transgender status, with resultant
health repercussions. This and other factors such as increased substance use, mental
health disorders, violence, and chronic stress may place transgender individuals at
higher risk for cardiovascular disease. Additionally, many transgender patients pursue
gender-affirming hormone therapy, which has been linked to increased rates of some
cardiovascular events such as metabolic syndrome, venous thromboembolism, and stroke.
Despite the likelihood of elevated cardiovascular risk in this population, there is
a paucity of published data about the cardiovascular risk of this population.
Methods
We present baseline cardiovascular data from a transgender population at a large tertiary
care center prior to the initiation of hormone therapy.
Results
The described transgender population had much higher rates of mental health disorders
and substance use than the general population. Furthermore, there were high rates
of undiagnosed and untreated comorbidities, such as hypertension and dyslipidemia,
that increase risk for cardiovascular disease. Baseline risk assessment using the
ASCVD (Atherosclerotic Cardiovascular Disease) and QRISK3 calculators showed higher-than-expected
cardiovascular risk, particularly given the young age of our patient population.
Conclusions
Transgender individuals are at high baseline cardiovascular risk. These data help
fill some important knowledge gaps in this patient subgroup, and provide us with much-needed
data to help guide our management and counseling of individuals seeking this type
of care.
Keywords
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Article Info
Publication History
Published online: April 22, 2021
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
