Cardiovascular health in transgender people

@article{Irwig2018CardiovascularHI,
  title={Cardiovascular health in transgender people},
  author={Michael S. Irwig},
  journal={Reviews in Endocrine and Metabolic Disorders},
  year={2018},
  volume={19},
  pages={243-251}
}
  • M. Irwig
  • Published 3 August 2018
  • Medicine
  • Reviews in Endocrine and Metabolic Disorders
This review examines the relationship between exogenous sex steroids and cardiovascular events and surrogate markers in trans (transgender) people. Data from trans populations is compared to data from postmenopausal women and hypogonadal men when appropriate. In an age-adjusted comparison with cisgender people, trans people appear to have an increased risk for myocardial infarction and death due to cardiovascular disease. It is uncertain whether hormone therapy in trans people affects their… 

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk

  • L. Seal
  • Medicine, Biology
    JRSM cardiovascular disease
  • 2019
The effect of gender affirming hormonal therapy in transgendered people is difficult to interpret due to the variety of hormone regimens used, the relative brevity of the periods of observation and the influence of confounding factors.

Transgender adults, gender-affirming hormone therapy and blood pressure: a systematic review

There is currently insufficient data to advise the impact of GHT on BP in transgender individuals and better quality research is essential to elucidate whether exogenous sex hormones modulateBP in transgender people and whether this putative alteration infers poorer cardiovascular outcomes.

Emerging topics in transgender medicine

  • V. Tangpricha
  • Medicine
    Reviews in Endocrine and Metabolic Disorders
  • 2018
It is found that there still remains a large majority of physicians who lack the expertise in transgender medicine and several interventions that have been effective in reducing this gap are reviewed.

Pathophysiological effects of androgens on the female vascular system

Long-term research is needed for the development of more consistent models and controlled experimental designs that will provide insights into the impact of endogenous androgen concentrations, testosterone doses for hormone therapy, and specific hormone types on function of the female cardiovascular system.

Affirming Hormone Treatment for a Transgender Adolescent After a Venous Thromboembolic Event

The possibility of testosterone therapy as a risk factor for venous thromboembolism during testosterone therapy for gender-affirming care may suggest the need to include this information during informed consent discussions.

Diagnosis, Treatment, and Prevention of Stroke in Transgender Adults

The use of gender-affirming hormone therapy may lead to an increased risk for ischemic stroke, but the data are limited and require further research, and a framework for healthcare providers to prevent and reduce disparities through inclusive care practices is provided.

Prevalence and Predictors of Cardiovascular Disease and Risk Factors in Transgender Persons in the United States

In this contemporary cross-sectional nationally representative survey, CVD was prevalent in nearly 14% ofTGD persons, and TGD persons with CVD were older with lower annual income and had higher rates of smoking, lower rates of regular exercise, and higher ratesof smoking and chronic medical comorbidities.

Cardiometabolic Effects of Testosterone in Transmen and Estrogen Plus Cyproterone Acetate in Transwomen

Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen; long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.
...

References

SHOWING 1-10 OF 49 REFERENCES

Sex Steroids and Cardiovascular Outcomes in Transgender Individuals: A Systematic Review and Meta‐Analysis

Low‐quality evidence suggests that sex steroid therapy may increase LDL‐C and TG levels and decrease HDL‐C level in FTM individuals, whereas oral estrogens may increase TG levels in MTF individuals.

Long-term evaluation of cross-sex hormone treatment in transsexual persons.

Cross-sex hormone treatment appears to be safe in transsexual men, but a substantial number of transsexual women suffered from osteoporosis at the lumbar spine and distal arm, and more attention should be paid to decrease cardiovascular risk factors during hormone therapy management.

Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: a case-control study.

Morbidity rate during cross-sex hormone therapy was relatively low, especially in trans men, and a higher prevalence of venous thrombosis, myocardial infarction, CVD, and type 2 diabetes in trans women than in the control population.

Postmenopausal Hormone Therapy and Risk of Stroke

The findings suggest that transdermal estrogens might be the safest option for short-term hormone therapy use, and both route of estrogen administration and progestogens were important determinants of IS.

Effect of cross-sex hormone treatment on cardiovascular risk factors in transsexual individuals. Experience in a specialized unit in Catalonia.

Hormone therapy for preventing cardiovascular disease in post-menopausal women.

High quality evidence is found that hormone therapy in both primary and secondary prevention conferred no protective effects for all-cause mortality, cardiovascular death, non-fatal myocardial infarction, angina, or revascularisation; the findings are dominated by the three largest trials.

Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people.

The large differential effect of oral EE and oral E(2) indicates that the prothrombotic effect of EE is due to its molecular structure rather than to a first-pass liver effect (which they share).

Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence.

Current treatment modalities were effective and carried a low risk for side effects and adverse events at short-time follow-up, and side effects, adverse events, and desired clinical changes were examined.

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones.

The increased mortality in hormone-treated MtF transsexuals was mainly due to non-hormone-related causes, but ethinyl estradiol may increase the risk of cardiovascular death, and use of testosterone in doses used for hypogonadal men seemed safe.