AHA: CVD Risk Often Unaddressed for Transgender Population

TUESDAY, Nov. 10, 2020 — Many transgender people receiving gender-affirming hormone therapy have cardiovascular disease risk factors, and a considerable proportion are not receiving appropriate therapies, according to a study presented at the American Heart Association Scientific Sessions 2020, held virtually from Nov. 13 to 17.

Kara J. Denby, M.D., from the Cleveland Clinic Foundation, and colleagues conducted a retrospective study of transgender patients seeking gender-affirming hormone therapy. For all patients who did not have documented cardiovascular disease, the American College of Cardiology/American Heart Association atherosclerotic cardiovascular disease (ASCVD) and QRISK3 risk scores were calculated.

The researchers found that 237 of the 427 patients who met the inclusion criteria had a chronic medical condition. The incidence of undiagnosed hypertension was 6.8 percent and the incidence of undiagnosed hyperlipidemia was 11.3 percent; 64.4 and 24.1 percent of those already diagnosed with hypertension and hyperlipidemia, respectively, were on appropriate therapies. For patients aged 40 to 65 years, the mean ASCVD risk and QRISK3 scores were 8.3 and 12.2 percent, respectively. For those ages 25 to 39 years, the mean QRISK3 score was 4.6 percent. Limited statin use was observed among patients who fell into intermediate- or high-risk categories.

“When we calculated the risk for developing a heart attack or stroke over 10 years, the risk for transgender men and women was higher than that reported for the average American of their age and gender,” Denby said in a statement. “We also found that, even in the highest risk individuals, many were not receiving recommended treatment.”

One author disclosed financial ties to the pharmaceutical industry.

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